2024-04-27T05:17:00Z https://academicjournals.org/oai-pmh/handler

oai:academicjournals.org:AATCVS:391034460799 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005

Construire le futur Fransois Ondo N#;dong Editorial Les Annales Africaines de Chirurgie Thoracique et Cardio-vasculaire sont l#39;un des derniers nes de la famille de la publication medicale africaine. Cette naissance vient remplir un espace d#39;echange et de communication, qui appelle toutes les societes scientifiques africaines a se mobiliser pour apporter l#39;information, vehiculrr le message, et construire une banque de donnees de recherche clinique, a l#39;usage de la pratique et de la recherche medicales africaines. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/391034460799 http://dx.doi.org/10.5897/AATCVS.9000010 en Copyright © 2005 Fransois Ondo N#;dong

oai:academicjournals.org:AATCVS:2 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005

Global expansion of Cardiothoracic Surgery. The african challenge A. T. Pezella Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/2 http://dx.doi.org/10.5897/AATCVS.9000013 en Copyright © 2005 A. T. Pezella

oai:academicjournals.org:AATCVS:5BE02FA60801 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005

A case of cardiac tumor observed in the point "G" hospital Boubacar Diallo, Sadio Yena, Kassoum Sanogo, Seydou Diakite, Ilo Bella Diall The heart can be the seat of neoplastic clinical demonstrations. In the case brought back here, the clinical picture associated to a recent and quickly increasing dyspnoca, a supirioir vena cava syndrome. The trans-thoracic echocardigraphy objectivised a tissulary mass and inhomogeneous two right cavities. The thoracic TDM confirmed the intra thoracic tumor with images of lymphangitidis carcinoma and of pleural infiltration. The echo guided pleural cytopoction allowed histological diagnosis of a sly nymphone. Evolution was fatal by cardiogenic shock. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/5BE02FA60801 http://dx.doi.org/10.5897/AATCVS.9000001 en Copyright © 2005 Boubacar Diallo, Sadio Yena, Kassoum Sanogo, Seydou Diakite, Ilo Bella Diall

oai:academicjournals.org:AATCVS:431F6A860802 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005

Traitement chirurgical des pericardites chroniques constrictives a Libreville Francois Ondo N#;dong, Sylvestre Mbamendame, Michel Ndong Assapi, J. Bernard M#;bourou, Madeleine Mella M#;Boumbia, Beatrice Koughou Boutamba, Nicolas Rousselot, Charles Diane In tropical Africa, constructive chronic pericarditis are essentially from tuberulous origin. If the diagnosis of this affection has neatly improved during these last years, because of our sanitary units acquiring soecialised explorations, the surgical treatment always leads to difficulties, related to material conditions. The goal of this study is to present the experience of the Thoracic Vascular and Visceral unit of the Fondation Jeanna Ebori, upon 18 cases operated from 1986 to 1999. It is a retrospective study. The patients were 14 males and 4 females, mean age 36 years old. Clinical signs were dominates by dyspnca, found in 11 patients (61.1%). 5 patients were in fonctionnal grade III, and 4 in grade IV. according to NYHA classification. 3patients presented signs of acute heart failure, 16 had a cardiomegaly. Tuberculous origin had been demonstrated in 7 cases, and HIV was found in 2 cases. All patients had the benefit of a medical treatment before their admittance in surgery. This treatment was based on administration of antituberculous and corticotherapy. The surgical treatment was motivated by the gravity of heart fonctionnal status, or resistance to medical therapy. 17 patients therefore had the benefit of a partial pericardiectomy, performed by left anterior thoractomy, 4 patients died post operatively, and 5 were lost in vue after getting out of the hospital. 1 patient died 5 years later, and 4 were lost in vue. 4 patients are under medial control unit now, and their clinical status is quite satisfying. Surgical treatment of constructive chronic pericarditis presents some particularities in our practise, according to his indications, technical procedures, and the results obtained; all of them are related to the material conditions of our units, and the patients#39; socio-economical conditions. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/431F6A860802 http://dx.doi.org/10.5897/AATCVS.9000031 en Copyright © 2005 Francois Ondo N#;dong, Sylvestre Mbamendame, Michel Ndong Assapi, J. Bernard M#;bourou, Madeleine Mella M#;Boumbia, Beatrice Koughou Boutamba, Nicolas Rousselot, Charles Diane

oai:academicjournals.org:AATCVS:664C66A60803 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005

Afferences diaphragmatiques et mediastinales du canal thoracique. Etude anatomique a partir de l'injection de la plevre diaphragmatique de foetus et de sujets adultes Godefroy Okiemy, Narcisse Ele, Jean Bernard Nkoua-Mbon, Boniface G. Ngouoni, Damase Bokilo The aim of this study was to determine connections between thoracic duct and lymphatic pathways of the diaphram, in order to better understand the propagation in the mediastinum of infectious of neoplastic processes, the tumorous recurrence, physiopathology of the chylothorax in surgey of lung cancer. Subpleural lymphatics of 30 adults cadavers and 12 fetuses were injected with a modified Gerota#39;s medium to permit lymph vessels and nodes to be visualized and then dissected. Each stage of the dissection was described and photographed. Diaphragmatic lymphatic afferents to the thoracic duct, originated from the posterior portion of the diaphram, were injected in 75% of cases (with 25% of direct connections). Mediastinal lymphatic lymph vessels (para-esophageal lymph patways) arose from posterior portion of diaphram, ascending along the esophagus and ending in the intertracheobronchial lymph nodes. Diaphragmatic and mediastinal lymphatic afferents to the thoiacic duct are playing a major role in intraleural cells resorption. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/664C66A60803 http://dx.doi.org/10.5897/AATCVS.9000003 en Copyright © 2005 Godefroy Okiemy, Narcisse Ele, Jean Bernard Nkoua-Mbon, Boniface G. Ngouoni, Damase Bokilo

oai:academicjournals.org:AATCVS:31B8E0160804 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005

Catamenial pneumothorax. A case report and review of the literature Mark Tettey, Lawrence Sereboe, Frank Edwin, Kwabena Frimpong-Boateng Catamenial pneumothorax is a spontaneous pneumothorax that occurs during menstruation. We present a case of catamenial pneumothorax which was treated with chemical pleurodesis after tube thoracostomy andunderwater sealed drainage. The diagnosis was established based on the history. She currently does not have recurrence of pneumothorax after five months of follow up, but complains of monthly chest pain. The pathophysiology and the current research in the management of catamenial pneumothorax are reviewed. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/31B8E0160804 http://dx.doi.org/10.5897/AATCVS.9000004 en Copyright © 2005 Mark Tettey, Lawrence Sereboe, Frank Edwin, Kwabena Frimpong-Boateng

oai:academicjournals.org:AATCVS:DF83AEC60808 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005

Diagnosting vascular diseases in our community - patient's complaints and doctor's constraints Gabriel U. Chianakwana Background: Contrary to previously held belief, vascular diseases are not rare in ou community. What is truly rare is our ability to pick up them when they present. Aims and Objectives: To study the cases of vascular diseases seen in our center, with a view to seeing how the diagnosis was made and how we can imrprove our diagnostic acumen. Design: Retrospective study. Settings: Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria, a tertiary institution, and Gabro Specialist Hospital, Nnewi Nigeria, a private hospital, both health establishments serving rural, semi-urban communities. Patients and Methods: Every patient who had a working diagnosis of any form of vascular disease, excluding trauma cases, from 1st June 2001 to 15th December 2004, was included in this study. Results: Two hundred and one pateints were identified. One hundred and three patients had varicose veins. Firty-four had deep vein thrombosis, 31 had peripheral arterial disease, 17 had different forms of vascular malformations and six had ancurysms. Most of the patients who were advised to do angiography or venography complained that they could not afford the hihg cost of the investigations in other centers. Our institution at that time did not have facilities for angiography. The diagnosis was made at post-mortem in two patients. Conclusions: With the exception of varicose veins, the index of suspicious for other vascular diseases is still very low in our community. In those patients in whom the diagnosis is highly suspected, diagnostic facilities are not readily available to confirm diagnosis or to asses the full extent of the disease. This is a big constraint. Patient#39;s poverty and the absence of any form of social welfare package in our community is another big constraint. A high index insurance scheme will certainly reduce patients#39; complaints and doctors#39; constraints and improve the care of patients with vascular diseases in our community. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/DF83AEC60808 http://dx.doi.org/10.5897/AATCVS.9000011 en Copyright © 2005 Gabriel U. Chianakwana

oai:academicjournals.org:AATCVS:D877E5660809 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005

One case of traumatic aortic dissection in Bamako (Mali) Boubacar Diallo, Sadio Yena Kassoum Sanogo, Seydou Diakite, Ilo Bella Diall, Eugen Ndirahisha It is about an observation of traumatic dissection of thoraco-abdominal aorta in an adult, somewhere else suffering from hypertensive cardiomyopathy. The clinical picture associated thoraco-lumbar pain, and the appearance of a formerly non-existence sign of aortic inssufficency. The etiology was considered as traumatic in front of the precession of a thoraco-abdominal shack. Clinically evoked diagnosis will be confirmed by the prints. The treatment remained medical because of the absence of heart surgery unit in Bamako and in front of the beggary of the patient not allowing him to be evacuated towards a better equpped centre. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/D877E5660809 http://dx.doi.org/10.5897/AATCVS.9000017 en Copyright © 2005 Boubacar Diallo, Sadio Yena Kassoum Sanogo, Seydou Diakite, Ilo Bella Diall, Eugen Ndirahisha

oai:academicjournals.org:AATCVS:8553F6960852 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006

Intensive care unit readmission after cardiac and thoracic surgery M. Tettey, E. Aniteye, L. Sereboe, D. Kotei, F. Edwin, M. Tamatey, K. Entsua-Mensah, K. Frimpong-Boateng Critical care services are one of the most demanding specialties in clinical practice and readmission to the intensive care unit has substantial financial and resource implications. Readmission and use of an expensive intensive care bed may be for a preventable complication. The aim of this study is to determine the readmission rate in the intensive care unit at the National Cardiothoracic Center, the causes of readmission, the mortality rate and to identify high risk patients who may need readmission. This was retrospective study which included patients admitted in the intensive care unit between 1st January 2001 to December 31st 2004. The records of all the cases readmitted were retrieved and information regarding the cause of readmission, management and outcome of management were recorded. Six hundred and three patients were admitted over the four year period at the Cardiothoracic intensive care unit (ICU) and there were eighteen readmissions. The readmission rate was 3.1%. The average length of stay of patients admitted in the ICU was 2.05 days and the average lenght of stay of readmitted patients was 3.9 days. The mortality patients admitted at the ICU was 2.3% and the mortality of readmitted patients was 27.8%. Congestive cardiac failure and chest infection after open heart surgery from 22.2% and 16.7% respectively and anastomic leakage after oesophagogastrosomy accounted for 27.8% of the readmissions. Other causes of ICU readmittions were infection of sternotomy (16.7%), dislodged electrode after permanent pacemaker implantation (11.1%) and a case of residual ventricular septal defect (5.5%). The study shows that readmission of cardiac and thoracic surgical patients to the ICU are low but are associted with a high morbidity and mortality. The average lenght of stay of readmitted patients in the ICU was about twice the admitted patients. Ederly patients who has oesophagectomy and intrathoracic oesophagogastrostomy are at a greatest risk of readmission and congestive cardiac failure is the major reason for ICU readmission after cardiac surgery. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/8553F6960852 http://dx.doi.org/10.5897/AATCVS.9000015 en Copyright © 2006 M. Tettey, E. Aniteye, L. Sereboe, D. Kotei, F. Edwin, M. Tamatey, K. Entsua-Mensah, K. Frimpong-Boateng

oai:academicjournals.org:AATCVS:29D837260853 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006

Pulmonary valvotomy under normothermic caval inflow occlusion Le Ngoc Thanh, Dang Hanh De, A. Thomas Pezzella Ffity nine patients underwent an operation between January, 1993 and April, 2000 for isolated pulmonary valve stenosis utilizing the inflow stasis technique. Patient ages ranged from 4 months to 44 years. All patients underwent preoperative two dimensional/doppler echocardiography (2D ECHO) to quantitate the peak systolic gradient between the right ventricle and pulmonary artery. Forty seven patients were studied postoperatively at one week, and forty nine were followed long term. The mean peak systolic gradient preoperatively was: 119.8 mmHg; one week postoperative: 30.07 mmHg, and long term: 17.7 mmHg. the average operative time for operative commisurotomy was one minute, thirty five seconds. There were no neurological complications. No patient required reoperation for residual stenosis. There were two perioperative deaths secondary to bleeding, (2/59)(3.3%). The overall results were good to excellent in 92%, fair in 6% and poor in 2%. Clinical examination and non invasive 2D ECHO has replaced cardiac catheterization to both confirm the clinical diagnosis and asswss the patients perioperatively. Pulmonary valvulotomy is an effective technique to alleviate isolated pulmonary valve stenosis, and is particularly applicable in emerging economies, like Vietnam. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/29D837260853 http://dx.doi.org/10.5897/AATCVS.9000022 en Copyright © 2006 Le Ngoc Thanh, Dang Hanh De, A. Thomas Pezzella

oai:academicjournals.org:AATCVS:2FCC88160854 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006

Chirurgie a coeur ouvert en côte d'ivoire. vingt annees d'experience chirurgicale Herve Yangni-Angate, Gregoire Ayegnon, Christophe Meneas, Florent Diby, Yves Yapobi, Michel Kangah The aim of this study is to report our surgical experience with open heart surgery in Cote d#39;Ivoire. From 1978 to 2000, 1665 patients have been operated on by cardiopulmonary by pass (CPB). There were 994 for acquired valvular heart diseases, 408 for congenital heart diseases and 263 for others cardiac diseases. Concerning vavular cardiac surgery (n = 994). 776 were monovavular (mitral n -606, aortic n = 126, triscupid n = 44), 215 were bivalvular (mitro-aortic n =44, mitro-tricuspid n= 100) and 3 trivavular. The mean age was 26 years (4-69 years_ and 52% of patients were in bad hemodynamic conditions (NYHA class III and IV). Rheumatic heart disease was the main etiolgy (n = 795, 80%) 936 valve replacement have been done (Bioprosthesis n = 470, Mechanical Prosthesis n = 466) versus 280 valvular repiar. Hospital and late mortality after CPB were respectively 8.5% and 11.3%. Among vavular heart disease, were 80 cases of Endomyocardial Fibrosis (right side form 23, left side form 17, bilateral form 40). Mean age was 10 years (2-15 years). Surgical procedures were endocardectomy plus valvuler reconstruction (n = 26) or valvular replacement (n = 54). The overall operative mortality was 12.5% (n + 10). Concerning congenital heart diseases (n = 408), the most frequent lesions were ventricular sepat defect (VSD) 100, atrial septal defct (ASD) 140, tetralogy of Fallot 100, partial atrioventricular cana 16. The corrective repair has been done in all cases. The overall mortality was 10% (n = 43). Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/2FCC88160854 http://dx.doi.org/10.5897/AATCVS.9000009 en Copyright © 2006 Herve Yangni-Angate, Gregoire Ayegnon, Christophe Meneas, Florent Diby, Yves Yapobi, Michel Kangah

oai:academicjournals.org:AATCVS:CE2AB7460857 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006

Thrombolys for blocked arterio-venous dialysis shunts E. Aniteye, M. Tettey, D. Kotei, L. Sereboe, F. Edwin, E. Jimenez, V. Amuzu, K. Frimpong-Boateng, Y. Adu-Gyamfi This was a retrospective study that looked at the effectiveness of thrombolytic agents in re-establishing flow in thrombosed Brescia-Cimino shunts for 10 patients on chronic dialysis. The thrombolysis was done in an intensive care setting under monitoring for arrhymias, hypotension and desaturation of blood. Of the ten patients 6 (60%) of them were male and 4 (40%) were famale. The average age of the patients was 53.9 + 5.73 years. Eight (80%) of the patients had internal jugular and 2 (20%) had subclavian central venous lines for the thrombolysis. Eight (80%) of the patients had streptokinase and 2 (20%) had urokinase for the thrombolysis. There was re-established flow in 9 (90%) of the shunts and the mean time for the re-establishment of flow in the A-V shunts was 7.56 + 1.07 hours. Two of the patients who had urokinase had previously been given streptokinase, one of a previous thrombosis of his A-V shunt and the other for myocardinal infarction. The commonest complication during the thrombolysis was bleeding (70%) followed by hypotension (50%) and nausea (40%). The hypotension and bleeding from the central venous lines was more common in the patients who were administered steptokinase. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/CE2AB7460857 http://dx.doi.org/10.5897/AATCVS.9000029 en Copyright © 2006 E. Aniteye, M. Tettey, D. Kotei, L. Sereboe, F. Edwin, E. Jimenez, V. Amuzu, K. Frimpong-Boateng, Y. Adu-Gyamfi

oai:academicjournals.org:AATCVS:AC4672860862 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006

The Klippel-Trenaunay-Weber Syndrome. A case report and literature review Francois Ondo N#;dong, Sylvestre Mbamendame, Folly-K Diallo-Owono, Mory, M. Kaba, MICHEL Ndong Assapi, Melina Nkole, Aboughe, Roselyne Bekale, Jean-Bernard Mbourou Association of bone and soft tissues hypertrophy, cutaneous haemangioma and superficial varicosity classically form the Klippel-Trenaunary-Weber syndrome. One case was diagnosed in a 12-year-old patient, admitted for a right lower limb congenital oedema. The goal of this study is to attract clinicians#39; attention upon this rare affliction with a difficult diagnosis and treatment. Clincally generalised oedema of the right limb was associated with voluminous superficial varicsity. A thrill was present at the internal side of the thigh, with a systolic murmur, indicating an arteriovenous fistula. Phlebography showed dilatation of deep venous network, compressin of the right superficial fermoral vein and doubling left deep femoral vein. Muscular echography revealed the presence of a compressing mass of tissues at the thigh level, which motivated the surgical procedure. It was a muscle in abnormal position trappng the deep vein, which was freed after muscle resection. The patient died 4 days post operatively, from massive pulmonary embolism. Diagnosis of Klippel-Trenaury-Weber syndrome must be considered when facing any congenital lower limb hypertrophy. Phlebography showing deep vascular lesions is an essential method of diagnosis. When surgical treatment is considered, the prevention of thromboembolic complications has to be instituted. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/AC4672860862 http://dx.doi.org/10.5897/AATCVS.9000028 en Copyright © 2006 Francois Ondo N#;dong, Sylvestre Mbamendame, Folly-K Diallo-Owono, Mory, M. Kaba, MICHEL Ndong Assapi, Melina Nkole, Aboughe, Roselyne Bekale, Jean-Bernard Mbourou

oai:academicjournals.org:AATCVS:40CD16160851 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006

Surgery of congenital heart diseases in Dakar, from a series of 102 Cases M. Ndiaye, O. Diarra, P. A. Dieng, O. Kane, A. Ndiaye, M. Ba, A. G. Ciss, Y. F. Mbodji, I. B. Diop The surgical treatment of congenital heart diseases is recent in our practice. As developing country, our surgical indications are adapted to our possibilities and only the operated patients are reported in this study. One hundred and two patients were operated on between 1992 and 2002. There were 54 patent ductus arterious (PDA), 27 cases of tetralogy of Fallot (TF), 17 cases of atrial setal defect (ASD) and 4 cases of complex cardiac malformations. The mean age was 7.02 years and the sex ratio 0.75. All the patients were operated either by palliative or curative surgery. The PDA were closed by section and suture in 30 cases (55.56%) and by ligation in 24 cases (44.44%). Surgery for TF was palliative in 26 cases (96.30%) and curative in 1 case (complete correction). The ASD were all closed surgically under cardiopulmonary bypass with a patch in 11 cases (64.70) or direct suture (35.30%). All patients with complex malformation were treated palliatively. Hospital mortality was 1.80% in PDA, 5.80% in ASD. 11.53% in palliatin of TF and 50% in complex malformation. Mean follow up time was 30 months. On adapting local surgical facilities and staff to treatment of congenital heart diseases patient can benefit of good outcome. Therefore further developments and organisation are necessary to cure all the malformations and to ensure correct follow-up. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/40CD16160851 http://dx.doi.org/10.5897/AATCVS.9000024 en Copyright © 2006 M. Ndiaye, O. Diarra, P. A. Dieng, O. Kane, A. Ndiaye, M. Ba, A. G. Ciss, Y. F. Mbodji, I. B. Diop

oai:academicjournals.org:AATCVS:6B95AEC68174 2011-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2011

Les Decortications Pulmonaires Au Centre Hospitalier Et Universitaire (Chu) Yalgado Ouedraogo P.G. BONKOUNGOU, G. BADOUM, G. OUEDRAOGO, Z. BONKOUNGOU, M. BAMBARA, Z. ADAMA, M. OUEDRAOGO Full Length Research Paper The aim of study is to report the indications and results of lung decortication at CHU Yalgado Ouedraogo. It is a retrospective study including all the patients who underwent lung decorticaion at CHU Yalgado Ouedraogo from May 2005 to March 2008. Lung decortication accounted for 50% of thoracotomies carried out for this period. 10 women and 6 men with an average age of 37 years old were concerning by this surgery. Para pneumonic empyema accounted for 56% of the indications. All patients were operated at the 3th stage evolution of the empyema after failure of antibiotic and chest succion. The average duration of surgery was 160 minutes. Blood transfusion was necessary in 60 % of the cases. Operative early post-operative mortality was zero. The average duration of suction was 5 days. The follow up showed a satisfactory pulmonary expansion in 75% of the cases. Lung decortication is the most frequent procedure in thoracic surgery in our centre without any early deaths. To reduce its indications implies a fast and effective management of pleural empyema. Key words: lung decortication - empyema Academic Journals 2011 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/6B95AEC68174 en Copyright © 2011 P.G. BONKOUNGOU, G. BADOUM, G. OUEDRAOGO, Z. BONKOUNGOU, M. BAMBARA, Z. ADAMA, M. OUEDRAOGO

oai:academicjournals.org:AATCVS:1A661EA68175 2011-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2011

Migrating Aspirated Foreign Body With Associated Intra-Atrial :Clot A Case Report A.KIGBU, O. OLADEJO, S.O. AJAYI, P.O. ADEOYE, O.O. OGUNKUNLE, S.I. OMOKHODION, A.G. FALADE Case Report The authors report a case of 10-year-old girl who presented with cough and breathlessness of 7 weeks and orthopnoea of 4 weeks. An earlier consultation at a private hospital revealed echocardiographic findings of right intra-atrial clot, confirmed at our institution. Plain chest radiographs showed right lower lobe consolidation and atelectasis. Cough worsened and she desaturated (SaO2 67%) on the 5th week of antibiotic therapy. Repeat plain chest radiographs showed left lung collapse. CT scanogram of the chest revealed no additional findings but Ventilation/Perfusion (VQ) scan of the lungs suggested a foreign body in the left main bronchus. Rigid bronchoscopy confirmed presence of foreign body in the left main stem bronchus but with failed attempt at removal. Postural drainage with physiotherapy effected expulsion which was confirmed at subsequent flexible bronchoscopy. Chest opacities cleared and the right intra-atrial clot resolved except for a flail tricuspid valve leaflet. We illustrate this case to emphasize the need for a high index of suspicion of foreign body aspiration in cases of persistent lung collapse especially in children and to document the rare co-existence with intra-atrial clot. Key words: Foreign Body Aspiration, Intra-atrial Clot, Pneumonia, Infective Endocarditis, Bronchoscopy. Academic Journals 2011 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/1A661EA68175 en Copyright © 2011 A.KIGBU, O. OLADEJO, S.O. AJAYI, P.O. ADEOYE, O.O. OGUNKUNLE, S.I. OMOKHODION, A.G. FALADE

oai:academicjournals.org:AATCVS:79E54A868169 2011-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2011

Atrial Septal Defect Closure In A 70 Year Old Woman: Case Report And Literature Review MN. Tamatey, A. Sereboe, MM. Tettey, F. Edwin, K. Entsua-Mensah, B. Gyan, Z. Delia, I. Okyere, S. Bello, A. Aniteye, A. Kotei, K. Frimpong-boateng Case Report Time was when it was thought that Atrial Septal Defects (ASDs) diagnosed in adulthood, especially in the elderly should only be managed conservatively. The trend is gradually changing and most ldquo;elderly ASDsrdquo; are getting closed, especially percutaneously if they are the ostium secumdum type. The Ostium primum, sinus venosus and coronary sinus ASDs still need open-heart surgery. We present the case of a woman who was diagnosed with an ostium primum ASD at the age of 65 years and had repair at 70 years. This is the oldest case of ASD closure done in this centre. The post operative and follow-up periods have been uneventful. Key words: Atrial septal defect, Ostium primum Atrial Septal Defect, Open-Heart surgery, percutaneous transcatheter repair. Academic Journals 2011 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/79E54A868169 en Copyright © 2011 MN. Tamatey, A. Sereboe, MM. Tettey, F. Edwin, K. Entsua-Mensah, B. Gyan, Z. Delia, I. Okyere, S. Bello, A. Aniteye, A. Kotei, K. Frimpong-boateng

oai:academicjournals.org:AATCVS:65684EA68173 2011-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2011

Angioplastie Pulmonaire Per-Operatoire Des Cardiopathies Congenitales KG. AYEGNON, E. BERGOEND, T. BOURGUIGNON, R. BONNEFOY, A CHANTEPIE, P. NEVILLE Full Length Research Paper Lrsquo;angioplastie percutaneacute;e des branches de l#39;artegrave;re pulmonaire (AP) peut ecirc;tre indiqueacute;e dans la steacute;nose eacute;tendue agrave; la chambre de chasse ventriculaire droite, mais limiteacute;e en cas de la complexiteacute; anatomique des branches de lrsquo;AP accompagnant les cardiopathies congeacute;nitales. Une approche hybride, associant une angioplastie de lrsquo;AP pendant lrsquo;opeacute;ration de la cardiopathie congeacute;nitale, peut ecirc;tre une alternative pour optimiser les suites post-opeacute;ratoires. Entre Octobre 2007 et Janvier 2010, 14 patients conseacute;cutifs ayant une steacute;nose de lrsquo;AP lieacute;e agrave; une cardiopathie congeacute;nitale ont subi une angioplastie pulmonaire per-opeacute;ratoire. Nous avons reacute;trospectivement analyseacute; des donneacute;es cliniques, des deacute;tails proceacute;duraux et lrsquo;eacute;volution de tous les patients. Des 14 patients (1 femme), 13 patients ont subi une prise en charge hybride de lrsquo;AP et 1 patient, une chirurgie de l#39;aorte ascendante. L#39;acirc;ge meacute;dian eacute;tait de 6.9 ans (extrecirc;me : 6 jours et 28 ans). Les diagnostics des cardiopathies primaires eacute;taient lrsquo;atreacute;sie pulmonaire (n = 7), la teacute;tralogie de Fallot (n = 5) et d#39;autre (n = 2). Lrsquo;AP gauche eacute;tait stenteacute;e chez 4 patients, le droit chez 1 patient et tous les deux chez 8 patients, pour un total de 22 stents, y compris celui dans l#39;aorte montante. Le diamegrave;tre maximal meacute;dian du ballonnet eacute;tait de 12 mm (extrecirc;mes : 6 et 25 mm). Les gestes chirurgicaux associeacute;s eacute;taient la reconstruction de la chambre de chasse droite agrave; lrsquo;aide drsquo;un patch (n = 8), le remplacement de la valve pulmonaire (n = 3) et d#39;autre (n = 3). La fixation du proximal de la prothegrave;se (stent) par une suture active a eacute;teacute; exeacute;cuteacute;e dans chaque cas. Aucune complication n#39;est survenue au cours de l#39;implantation du stent. En peacute;ri-opeacute;ratoire, aucune complication cardiaque significative n#39;a eacute;teacute; noteacute;. Le deacute;lai meacute;dian drsquo;hospitalisation en soins intensifs eacute;tait 2 jours (extrecirc;mes : 2 et 7 jours). Le suivi moyen eacute;tait 9.8 mois (extrecirc;mes : 1 et 19 mois). Lrsquo;eacute;chocardiographie de sortie a montreacute; de bons reacute;sultats morphologiques et heacute;modynamiques de lrsquo;AP des branches : le gradient maximal moyen eacute;tait 3.8 mmHg (extrecirc;mes : 0 et 14 mmHg). Juste apregrave;s la proceacute;dure, on notait une ameacute;lioration significative de la pression ventriculaire systolique dans la majoriteacute; des cas. Aucune re-dilatation du stent n#39;a eacute;teacute; neacute;cessaire. Lrsquo;angioplastie de lrsquo;AP au cours de la chirurgie des cardiopathies congeacute;nitales est une alternative agrave; l#39;angioplastie traditionnelle en cas de steacute;nose complexe de lrsquo;AP. La proceacute;dure est efficace, sucirc;r et preacute;vient ou ameacute;liore le dysfonctionnement ventriculaire droit. Mots cleacute;s : Artegrave;re Pulmonaire, Cardiopathie congeacute;nitale, Stent, Steacute;noses. Academic Journals 2011 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/65684EA68173 en Copyright © 2011 KG. AYEGNON, E. BERGOEND, T. BOURGUIGNON, R. BONNEFOY, A CHANTEPIE, P. NEVILLE

oai:academicjournals.org:AATCVS:6F8E59A68171 2011-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2011

Le Drainage Chirurgical pour Pericardites Liquidiennes Dakar P.A. DIENG, A.G. CISS, S. DIATTA, O. DIARRA, P.S. BA, A. NDIAYE, M. GAYE, M. LEYE, O. KANE, M. Full Length Research Paper Notre eacute;tude a pour but de deacute;terminer la morbi-mortaliteacute; et les eacute;tiologies des peacute;ricardites liquidiennes agrave; Dakar. Patients et meacute;thodes: Il srsquo;agissait drsquo;une eacute;tude reacute;trospective de 1994 agrave; 2008 colligeant 55 dossiers de patients opeacute;reacute;s dans le service de chirurgie cardiovasculaire du CHU de Dakar. La triade dyspneacute;e-toux-fiegrave;vre dominait le tableau clinique. Les malades en tamponnade repreacute;sentaient 39,5%.A lrsquo;eacute;chographie, lrsquo;eacute;panchement circonfeacute;rentiel dominait le tableau (76,7%).La ponction peacute;ricardique preacute;alable a eacute;teacute; reacute;aliseacute;e chez 35 patients (63,6%).Le drainage peacute;ricardique par voie sous-xiphoiuml;dienne avait permis lrsquo;eacute;vacuation de lrsquo;eacute;panchement et la reacute;alisation drsquo;une biopsie. Lrsquo;eacute;tiologie tuberculeuse eacute;tait preacute;dominante (40%), avec la peacute;ricardite non speacute;cifique (40%), la peacute;ricardite congestive eacute;tait agrave; 18%, et la peacute;ricardite rhumatismale agrave; 18%. Il nrsquo;y avait pas drsquo;eacute;tiologie neacute;oplasique. Les suites opeacute;ratoires eacute;taient simples dans 81,4% des cas. Les complications eacute;taient surtout infectieuses. La mortaliteacute; eacute;tait de 5,45%(3cas). Le drainage chirurgical est une intervention sucirc;re qui permet une deacute;compression rapide et continue du peacute;ricarde, et permet de retrouver dans la plupart des cas, une eacute;tiologie qui favorise une meilleure prise en charge theacute;raoeutique. Mots-cleacute;s: drainage, chirurgie, peacute;ricardite Academic Journals 2011 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/6F8E59A68171 en Copyright © 2011 P.A. DIENG, A.G. CISS, S. DIATTA, O. DIARRA, P.S. BA, A. NDIAYE, M. GAYE, M. LEYE, O. KANE, M.

oai:academicjournals.org:AATCVS:7B7960968192 2013-01-30T00:00:00Z AcademicJournals AATCVS AATCVS:2013

Pediatric Thoracic Hydatid Cysts in Peru : Case Report and Review V. Eneida, H. Melgar, B. Alfredo, M. Hernandez Grau, R. Fernando, R. Chavarri Velarde, A. Thomas Pezzella Full Length Research Paper Hydatid cyst secondary to the parasite Echinococcus granulosus, involving the lung parenchyma, is an endemic disease in Peru, especially in the rural areas involved with animal domestication. Despite aggressive government public health directives for prevention, poor recognition and compliance remain major factors in human infection, especially in children. Medical treatment alone is not effective in the majority of either asymptomatic or symptomatic patients with documented thoracic disease. Surgery remains the primary recommended approach. Over 30 thoracic procedures are performed annually at the Instituto Nacional de Salud del Nino, in Lima, Peru for thoracic hydatid cysts. The present clinical case illustrates the contemporary surgical approach to this preventable disease in Peru, along with some unifying surgical concepts. Key Words: Hydatid cyst disease; Capitonnage; Endoplication Simple cyst; Lung sparing surgery; Endemic disease Academic Journals 2013 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/7B7960968192 en Copyright © 2013 V. Eneida, H. Melgar, B. Alfredo, M. Hernandez Grau, R. Fernando, R. Chavarri Velarde, A. Thomas Pezzella

oai:academicjournals.org:AATCVS:F59EC7C68189 2013-01-30T00:00:00Z AcademicJournals AATCVS AATCVS:2013

TRAITEMENT DES HYPERPLASIES THYMIQUES : A PROPOS DE 5 CAS OPERES O. Diarra, A. G. Ciss, S. Mbamendame, P. A. Dieng, P. S. Ba, S. Diatta, M. Gaye, A. Ndiaye, O. Kane, M. Ndiaye Full Length Research Paper Les hyperplasies thymiques se caracteacute;risent par une pathogeacute;negrave;se complexe et des tableaux cliniques varieacute;s sources drsquo;attitudes theacute;rapeutiques controverseacute;es. Insister sur la rareteacute;, les difficulteacute;s diagnostiques et rapporter les reacute;sultats de la chirurgie dans les hyperplasies thymiques. Dans cette eacute;tude reacute;trospective 5 dossiers de patients opeacute;reacute;s pour une hyperplasie thymique entre 1995 et 2005 ont eacute;teacute; eacute;tudieacute;s. Il srsquo;agissait de 2 cas drsquo;hyperplasie thymique vraie (type I), de 2 cas drsquo;hyperplasie thymique lympho-folliculaire (type II) et drsquo;un cas drsquo;hyperplasie thymique massive (type III). Les donneacute;es preacute;-opeacute;ratoires, la technique chirurgicale et ses reacute;sultats ont eacute;teacute; analyseacute;s. Le recul moyen a eacute;teacute; de 3,38 ans. La seacute;rie comptait 3 hommes (1 pour chaque type) et 2 femmes (1 pour le type I et 1 pour le type II), drsquo;acirc;ge moyen eacute;gal agrave; 14,70 ans. Dans les types I et III, les signes respiratoires eacute;taient dominants. Dans le type II, en plus des signes respiratoires, un syndrome myastheacute;nique eacute;tait preacute;sent. Lrsquo;imagerie thoracique avait permis drsquo;objectiver une augmentation de la taille du thymus dans 4 cas (2 cas pour le type I, 1 pour le type II et 1 pour le type III). Tous les patients avaient beacute;neacute;ficieacute; drsquo;une thymectomie totale par sternotomie meacute;diane. Les suites opeacute;ratoires eacute;taient simples. Apregrave;s un recul reacute;sultats eacute;taient jugeacute;s satisfaisants. moyen de 3,38 ans, les Les hyperplasies thymiques sont rares. Elles constituent un groupe heacute;teacute;rogegrave;ne dont le traitement reste controverseacute;. La chirurgie demeure le traitement de choix en milieu sous meacute;dicaliseacute; ou lorsque le suivi meacute;dical des patients est aleacute;atoire. Mots-cleacute;s : Hyperplasie thymique, Diagnostic, Chirurgie. Academic Journals 2013 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/F59EC7C68189 en Copyright © 2013 O. Diarra, A. G. Ciss, S. Mbamendame, P. A. Dieng, P. S. Ba, S. Diatta, M. Gaye, A. Ndiaye, O. Kane, M. Ndiaye

oai:academicjournals.org:AATCVS:7F427F768188 2013-01-30T00:00:00Z AcademicJournals AATCVS AATCVS:2013

DEVICE OCCLUSION OF ATRIAL SEPTAL DEFECT THROUGH MINIMALLY INVASIVE RIGHT ANTERIOR CHEST APPROACH L. I. Feng, W. U. Weihua, A. T. Pezzella Full Length Research Paper Occlusion of atrial septal defects through a small right chest incision is minimally invasive and safe. Academic Journals 2013 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/7F427F768188 en Copyright © 2013 L. I. Feng, W. U. Weihua, A. T. Pezzella

oai:academicjournals.org:AATCVS:099FC4068185 2013-01-30T00:00:00Z AcademicJournals AATCVS AATCVS:2013

CALCIFIED PSEUDO-ANEURYSM OF ASCENDING AORTA FROM CANNULATION SITE ERODING INTO THE STERNUM : A CASE REPORT Jalal Jolou, Charumathi Dasarathan, Prashant Vaijyanath, A. Thomas Pezzella, K. M. Cherian Full Length Research Paper We report the successful surgical treatment of a nonmycotic pseudoaneurysm of the ascending aorta in a 15 year old male who underwent surgical closure of an atrial septal defect at the age of 3 years. A Computed Tomography (CT) scan was performed to investigate the palpable mass on the healed sternotomy scar. It revealed a densely calcified nonmycotic pseudoaneurysm of the ascending aorta (9.5x 5.5 cm) arising from the prior cannulation site, and eroding into the sternum. Since the aneurysm and the ascending aorta were heavily calcified and adherent to the adjoining structures, it was repaired using a bovine pericardial gusset. The cause of the pseudoaneurysm was considered iatrogenic. Key Words: Pseudoaneurysm, Aortic cannulation site, Congenital Heart Disease, Calcified ascending aorta Academic Journals 2013 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/099FC4068185 en Copyright © 2013 Jalal Jolou, Charumathi Dasarathan, Prashant Vaijyanath, A. Thomas Pezzella, K. M. Cherian

oai:academicjournals.org:AATCVS:7CCC9C168180 2013-01-30T00:00:00Z AcademicJournals AATCVS AATCVS:2013

SUIVI A LONG TERME DE 80 PATIENTS OPERES D’UNE DISSECTION AORTIQUE AIGUË DE TYPE A/LONG-TERM FOLLOW-UP OF 80 PATIENTS OPERATED FOR AN ACUTE AORTIC DISSECTION TYPE A K. G. AYEGNON, A. MIRZA, K. H. YANGNI-ANGATE, E. BERGOEND, T. H. BOURGUIGNON, M. AUPART, M. MARCHAND Full Length Research Paper Identifier et eacute;valuer les facteurs de risque de morbi-mortaliteacute; agrave; court et long terme drsquo;une dissection aortique aigueuml; de type A de Stanford. Crsquo;est une eacute;tude reacute;trospective de 80 patients (57 hommes et 23 femmes) conseacute;cutifs opeacute;reacute;s drsquo;une dissection aortique aigueuml; de type A de Stanford entre janvier 1991 et Deacute;cembre 2008. 59 dissections concernaient lrsquo;aorte thoracique ascendante et descendante (type I De Bakey) et 21, lrsquo;aorte ascendante uniquement (type II De Bakey). Suivant les techniques chirurgicales, la mortaliteacute; et la morbiditeacute; ont eacute;teacute; eacute;valueacute;es par des courbes actuarielles. Les facteurs pronostiques preacute;, per et post opeacute;ratoires ont eacute;teacute; eacute;valueacute;s par analyse uni et multi varieacute;e. Les variables uantitatives ont eacute;teacute; compareacute;es par le test parameacute;trique de Student et les variables qualitatives par le test morphologique de lrsquo;aorte a eacute;teacute; faite par IRM ou TDM chez les survivants. de khi deux. Lrsquo;eacute;valuation. La mortaliteacute; hospitaliegrave;re a eacute;teacute; de 17,5 %. La survie actuarielle agrave; 17 ans est de 27 plusmn; 7%. En analyse univarieacute;e, les facteurs associeacute;s agrave; la mortaliteacute; hospitaliegrave;re ont eacute;teacute;: IDM preacute;-opeacute;ratoire et ischeacute;mie meacute;senteacute;rique (p = 0,01), le taux de prothrombine lt; 72 % (p = 0,01) et lrsquo;alteacute;ration de la fonction ventriculaire droite et / ou gauche (p = 0,01). La mortaliteacute; preacute;coce post-opeacute;ratoire eacute;tait lieacute;e agrave; lrsquo;insuffisance reacute;nale seacute;vegrave;re (p = 0,03), lrsquo;IDM preacute;-opeacute;ratoire (p = 0,002) et au choc cardiogeacute;nique preacute;-opeacute;ratoire (p=0,05). Les complications preacute;coces eacute;taient une infection broncho-pulmonaire (43,75 %), une insuffisance reacute;nale transitoire (22 %) et les arythmies chronique (n = 12), la persistance seacute;vegrave;res (15,20%). Les complications tardives ont eacute;teacute; la dissection drsquo;un faux chenal circulant post-opeacute;ratoire (n = 27) et des faux aneacute;vrismes post-opeacute;ratoires (n = 12). La morbi-mortaliteacute; eacute;tait eacute;leveacute;e dans le type I de De Bakey. La survie agrave; 1 an, agrave; 5 ans, agrave; 10 ans et agrave; 15 ans eacute;tait respectivement de 75 %, 66 %, 52 % et 30 %. La chirurgie de la dissection aigueuml; de lrsquo;aorte de type A de Stanford donne des reacute;sultats satisfaisants agrave; moyen et long terme notamment dans le type II de De Bakey. Mots cleacute;s : Dissection aigueuml; ndash;aorte, mortaliteacute;, morbiditeacute;, suivi. Academic Journals 2013 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/7CCC9C168180 en Copyright © 2013 K. G. AYEGNON, A. MIRZA, K. H. YANGNI-ANGATE, E. BERGOEND, T. H. BOURGUIGNON, M. AUPART, M. MARCHAND

oai:academicjournals.org:AATCVS:00C55FC60839 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Traumatic chylothorax: a case report MN. TAMATEY, LA. SEREBOE, MM. TETTEY, K. ENTSUA-MENSAH, B. GYAN, IK. ADZAMLI Case Report Chylothorax is an uncommon condition, and more so chylothorax secondary to blunt trauma. However, when it occurs it can be debilitating and life threatening, unless appropriate treatment is instituted on time. We present the case of a 39-year old man who felt from a height and developed chylothorax secondary to blunt trauma, amidst other injuries. He was admitted, managed conservatively and discharged home 17 days later in satisfactory condition. Keywords: chylothorax, blunt trauma, conservative management, Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/00C55FC60839 http://dx.doi.org/10.5897/AATCVS.9000032 en Copyright © 2015 MN. TAMATEY, LA. SEREBOE, MM. TETTEY, K. ENTSUA-MENSAH, B. GYAN, IK. ADZAMLI

oai:academicjournals.org:AATCVS:787030C60832 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Acute lower limbs ischemia in Bamako (Mali) B. TOGOLA, S. TOGO, B. COULIBALY, M. OUATTARA, S. SANOGO, D. TRAORE, B. BENGALY, A. TOGO, ZZ. SANOGO, S. KEITA, H. DICKO, S. YENA, N. ONGOIBA, F. SISSIKO Full Length Research Paper The aim of this work was to analyze the results of the management of acute lower limbischemia. Materials and methods : It was a retrospective study for 12 years (2000 -2011) at teaching hospital Point ldquo;Grdquo; Bamako. The medical files and the operational reports of the patients dealt with for acute arterial ischemia of the lower limb were re-examined. Results: We managed 50 patients for an acute lower limb ischemia.There were 68% (n=34) men for 32% (n=16) women. The mean age was 59 years plusmn; 23 years. The median interval with the surgical consultation was 37 days. The same cardiovascular risk factors were tobacco 44% (n=22), HTA 42% (n=21), diabetes 16% (n=8). In surgical consultation (n=44) 88% of the patients had already a gangrene of the lower limb. Echo-Doppler was carried out at 88% of the patients (n=44). According to the classification of Rutherford there were 88% of class III (n=44) and 12% of class II B (n=6). The site of occlusion were popliteal artery in 38% (n=19), leg arteries 30% (n=15), femoral artery 28% (n=14). The major etiologic mechanisms of arterial ischemia were an embolism in 50% (n=25) whose cardiac cause was found at 22% (n=11), a thrombosis in 50% (n=25). Acute ischemia had occurred on an arteriopathy obliterating chronic at 31 patients (62%). Only 3 patients (6%) of the patients had profited from a heparin therapy before the surgical consultation. Initial amputation was carried out at 31 cases (66%), a thrombo-embolectomy with the catheter of Fogarty in 4 patients (8,5%), embolectomy with Fogarty procedure associated to an amputation in 25,5% (n=12) and secondary amputation in 3 cases (6,5%). The outcomes were simple in 91,5% of our patients (n=43). Overall mortality was 8% (n=4). Conclusion: An early diagnosis and an early therapeutic associate to an adapted technical structure can improve our results. Key words: Acute - ischemia-lower limb - surgery Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/787030C60832 http://dx.doi.org/10.5897/AATCVS.9000002 en Copyright © 2015 B. TOGOLA, S. TOGO, B. COULIBALY, M. OUATTARA, S. SANOGO, D. TRAORE, B. BENGALY, A. TOGO, ZZ. SANOGO, S. KEITA, H. DICKO, S. YENA, N. ONGOIBA, F. SISSIKO

oai:academicjournals.org:AATCVS:95E9BFF60827 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Total intra-cardiac repair of cyanotic congenital heart disease in Accra – 20 years experience MN. TAMATEY, LA. SEREBOE, MM. TETTEY, F. EDWIN, EA. ANITEYE, DA. KOTEI, K. ENTSUAMENSAH, B. GYAN, EA. OFOSU-APPIAH, IK ADZAMLI Full Length Research Paper Objective: To analyse the spectrum of cyanotic congenital heart disease that had total intra-cardiac repair in this Centre and the outcome over a 20-year period. Patients and Methods: A retrospective study was done for all patients who had intra-cardiac repair for cyanotic congenital heart disease from January 1992 to December 2011. Results: There were 115 cases, with 56.5% of them being male. The modal age group was 5 ndash; 9 years (45.2%), with a mean of 8.5 plusmn; 5.3 years. Tetralogy of Fallot (TOF) comprised the majority of cases (n=108; 93,1%), with double outlet right ventricle (DORV) forming the remaining 7 cases (6,9%). Most of the TOFs, 78 (72.2%) needed palliation with a Modified Blalock-Taussig Shunt (MBTS), whilst the remaining 30 (27.8%) had primary correction. The mean duration of an MBTS before total repair was 2.3 years. Ten (9.3%) of the TOF patients had bilateral MBTS due to occlusion of the first shunts. The overall complication rate was 19.1% (22 cases). This was due to bleeding requiring re-exploration in one patient (0.9%), acute renal failure (ARF) requiring dialysis (n=1; 0,9%), complete heart block requiring permanent pacemaker implantation (n=4; 3,4%) and the 30-day mortality of 16 patients (13,9%). Conclusion: Presently, total intra-cardiac repair is the logical conclusion in the management of most cyanotic congenital heart diseases. Excellent long-term survival following total repair has been reported in many studies. This study revealed acceptable complication rates and a good outcome. Keywords: Intra-cardiac repair, cyanotic, congenital heart disease Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/95E9BFF60827 http://dx.doi.org/10.5897/AATCVS.9000030 en Copyright © 2015 MN. TAMATEY, LA. SEREBOE, MM. TETTEY, F. EDWIN, EA. ANITEYE, DA. KOTEI, K. ENTSUAMENSAH, B. GYAN, EA. OFOSU-APPIAH, IK ADZAMLI

oai:academicjournals.org:AATCVS:0FB353260822 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Mitro-tricuspid valve disease: Cote d’Ivoire surgical experience KH. YANGNI-ANGATE, KG. AYEGNON, F. DIBY, GC. MENEAS, M. DIOMANDE, KA. ADOUBI, F. KENDJA, Y. TANAUH Full Length Research Paper The objective of this study was to report our experience on mitro-tricuspid valve disease treated surgically. Material and Methods: 72 patients with mitro-tricuspid valve disease were collected between December 1983 and November 2009. We have studied the epidemiological, clinical, paraclinical and therapeutic data. Only patients with mitral disease (mitral regurgitation and mitral stenosis) associated with tricuspid insufficiency (TI) or mitral stenosis associated with tricuspid regurgitation were included. All patients with an isolated tricuspid stenosis were excluded from the study. Retrospectively, we analyzed surgical results with a statistic significance level of 0.05. Results: Median age of patients was 19 years old. Sex ratio was 2 Women / 1Homme. 61.1% of patients had a functional class NYHA III or IV. The dominant etiology was the Acute Rheumatic Disease in all cases. The mean cardiothoracic ratio (RCT) was 0.67 plusmn; 0.12 with a sinus rhythm (44.4%) and atrial fibrillation (56.6%). The bi-dimensional echocardiography was contributory in all patients. At Cardiac catheterization with Angiocardiography, Mean diastolic pressure of the Right Ventricle was 40.20 plusmn; 20.75 mmHg and Mean pulmonary arterial hypertension was 41.15 plusmn; 11,81mmHg. The surgical procedures were a replacement (n = 68) or valvuloplasty (n = 4) of the mitral valve associated with a tricuspid Annuloplasty (AT) or not. 42 AT of De Vega and 10 AT of Carpentier-Edwards were performed. Then, 20 TI were surgically neglected. Operative mortality was 2.8 % (n = 2). It was mainly due to the neglected TI. 2 deaths were due to a cardiogenic shock secondary a global cardiac failure (n = 2) to (n = 1). Post-operatively, 12.5 % and 7.14 % of the earliest complications were respectively observed in case of neglected TI and in case of TA of De Vega (p = 0.045). Post-operatively, the latest global morbidity was 27.8 %. These complications have happened differently in case of neglected TI or of TA of De Vega (P = 0.039). A clinical and radiological improvement were observed at least for 4 out of 5 patients treated by the TA of De Vega during the mitral valve replacement. Echocardiographic regression of the tricuspid leak was 1 plusmn; 0,75 rank. In the long term follow up, the risk factor significantly associated with the arisen of complications was the neglected TI (RR = 5.77; P = 0.03). 10 years follow-up, the late cardiac catheterization showed tricuspid leaks were small (grad I = 36; 56.3 %), moderated (grad II = 20; 31.3 %), important (grad III = 6; 9.4 %) and very important (grad IV = 2; 3.1 %). Conclusion: Our results show that the neglected IT seems to aggravate the evolution of mitro-tricuspid valve disease after surgery. Nevertheless, more important series will be necessary to confront assertion. Keywords: Tricuspid regurgitationndash; mitral valve Surgery. Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/0FB353260822 http://dx.doi.org/10.5897/AATCVS.9000016 en Copyright © 2015 KH. YANGNI-ANGATE, KG. AYEGNON, F. DIBY, GC. MENEAS, M. DIOMANDE, KA. ADOUBI, F. KENDJA, Y. TANAUH

oai:academicjournals.org:AATCVS:3BEAE3460814 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Risk factors for morbidity and mortality after ascending aorta aneurysms repair AG CISS, K. AZARNOUSH, L. CAMILLERI, B. PEREIRA, A. INNORTA, B. LEGAULT, A. GEOFFROY, B. COSSERANT, C. DE RIBEROLLES, M. Nrsquo;DIAYE Full Length Research Paper Objective: The aim of this study is to assess the mortality and morbidity factors of surgery for ascending aorta aneurysm. Methods: This is a retrospective study of 229 sheet records of patients who underwent ascending aorta replacement for aneurysm; the statistical analyze permitted to assess the mortality and morbidity factors. Results: A replacement of the ascending aorta with the aortic valve (Bentall) was done in 33%, and without replacement of the aortic valve (David) in 15 % of patients. A supra coronary replacement of the aorta was done in 52% of patients while 5 % had the aortic valve not replaced. Preoperative morbidity factors were: addition of medical risk factors, supra coronary replacement of the aorta without replacement of the aortic valve. Post-operative factors were: use of inotropes and long ICU stay. Global mortality, including hospital mortality was 4% (9 patients). The only preoperative factor of mortality was hypothermia and the only post-operative factor decreased ejection fraction. Conclusion: The bad prognosis factors were non treatment of a lesion the aortic valve, ventricular dysfunction and surgery extended to the horizontal aorta. Keys worlds: mortality, morbidity, aortic aneurysm Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/3BEAE3460814 http://dx.doi.org/10.5897/AATCVS.9000023 en Copyright © 2015 AG CISS, K. AZARNOUSH, L. CAMILLERI, B. PEREIRA, A. INNORTA, B. LEGAULT, A. GEOFFROY, B. COSSERANT, C. DE RIBEROLLES, M. Nrsquo;DIAYE

oai:academicjournals.org:AATCVS:480F64460849 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Outcomes of abdominal aortic aneurysm repair in Immunodeficiency Virus (HIV) positive patients H. KAKRA, A.HARDY-HENRY, C. GANDOTRA, C. HUYNH, A. OBIRIEZE, D. TRAN, E. CORNWELL III, K. AMANKWAH Full Length Research Paper Background: HIV-infected patients are at an increased risk for accelerated vascular disease. Abnormal endothelial function and aneurysmal dilation of the large arteries have been described; however, data is lacking on the outcomes of HIV-infected patients undergoing abdominal aortic aneurysm (AAA) repair on a national level. Methods: This study is a retrospective analysis of hospital discharge data using the Nationwide Inpatient Sample Database from 2001 ndash; 2009. HIV-infected patients undergoing abdominal aortic aneurysm repair were included. Results: From 2001 to 2009, we identified 23 HIV-infected patients who underwent abdominal aortic aneurysm repair, with a mean age of 56 (plusmn;12). Of these, 14 (61%) had open repair, while 9 (39%) had endovascular repair; four of the open repair patients presented with ruptured AAA. There were two postoperative deaths after open repair (9% mortality), 1 death from the ruptured AAA open repair group and 1 death from the non-ruptured open repair group. Three cases in the ruptured open group had sepsis, and one patient had both respiratory and graft complications. In the non-ruptured open group, one patient developed sepsis and cardiac complications. There were no mortalities in the endovascular group, although 1 patient developed sepsis and 2 had cardiopulmonary complications. Conclusions: Perioperative outcomes appear to be similar for HIV positive patients who undergo open and endovascular AAA repair compared to HIV negative patients. Keywords: abdominal aortic aneurysm, repair, HIV Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/480F64460849 http://dx.doi.org/10.5897/AATCVS.9000020 en Copyright © 2015 H. KAKRA, A.HARDY-HENRY, C. GANDOTRA, C. HUYNH, A. OBIRIEZE, D. TRAN, E. CORNWELL III, K. AMANKWAH

oai:academicjournals.org:AATCVS:A16FC7F60883 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Outcome of feeding enterostomy for nutritional rehabilitation in dysphagia N. ANUMENECHI, S.A. EDAIGBINI, M.B. AMINU, I.Z. DELIA Full Length Research Paper Background: feeding enterostomy is used to build up patients with dysphagia bj definitive surgery. Objective: to evaluate the achievement of nutritional goals in dysphagia patients and to suggest management protocols. Methodology: A retrospective study of feeding enterostomies for dysphagia over 4 years. The preoperative, post-operative weights and progression to definitive esophageal replacement were analyzed. Results: There were 34 patients, records were available for 29 patients, ages ranged from 1.5 to 90 years, mean age was 29.7years, and male to female ratio was 3:7. The causes of dysphagia were corrosive esophageal stricture-12, esophageal cancer-13, pharyngeal tumor-3 and mediastinal mass 1. The duration of symptoms ranged from 3 weeks to 106 weeks (mean 26.4 weeks). Preoperative weight ranged from 6.2 ndash; 68 kg (mean 24.1kg), postoperative weight was between 7 ndash; 65 kg (mean 25.7kg); follow up period ranged from 0.5 to 12 months (mean 3.2 months), weight gain was negative for those who had their last weight check by 6 weeks post op (p value 0.057). 15 patients (52%) proceeded to have definitive esophageal replacement surgery. Conclusion: Feeding enterostomy was successful in nutritional rehabilitation of dysphagia patients and 6 weeks may be required to appreciate positive weight gain. There is a need for standard protocols for better management and follow-up of these patients. Key-words : Feeding enterostomy, Dysphagia, Outcome, Rehabilitation. Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/A16FC7F60883 http://dx.doi.org/10.5897/AATCVS.9000019 en Copyright © 2015 N. ANUMENECHI, S.A. EDAIGBINI, M.B. AMINU, I.Z. DELIA

oai:academicjournals.org:AATCVS:DFA8B1660868 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Difficulties in the management of civilian peripheral vascular trauma and their complications at the University Teaching Hospital of Yaoundé, Cameroon B. NGO NONGA-, EP. SAVOM, GA. BANG, GM LONDJI, AG. ESSOMBA- Full Length Research Paper Background. The incidence of peripheral vascular lesions remains undetermined in Cameroon. The objective of this study is to report our experience with the management of peripheral vascular trauma in civil life at the University Teaching Hospital of Yaoundeacute;. Patients and methods. We have reviewed retrospectively all the cases of peripheral vascular trauma treated at the Yaoundeacute;rsquo;s University Teaching Hospital between 2008 and 2010. We excluded all patients with crushing members or traumatic amputations. Case notes were reviewed for demographic factors, nature of trauma, vascular injury observed and treatment applied. Results. We found 12 patients on 2,436 trauma giving a prevalence of 0.5%. There were 11 men and one woman, mean age was 28.5 (18-55) years. All patients were victims of a penetrating wound. Nine patients were received at the stage of complications from 6 weeks to 2 years after the trauma: 5 of them had an arteriovenous fistulas and the other four presented with pseudo aneurysms, they were all operated successfully. Three patients came in emergency at the time of the injury and they presented lesions to the popliteal vessels, brachial and radial arteries. They were amputated after a failed attempt revascularization performed beyond 6 hours after trauma. Conclusion. Vascular injuries are usually overlooked in our environment, and we would recommend a vascular exam in patients with penetrating injuries to the limb to avoid missing them. Keywords. Penetrating injury ndash; peripheral vascular trauma - pseudo- neurysmarteriovenous fistula. Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/DFA8B1660868 http://dx.doi.org/10.5897/AATCVS.9000012 en Copyright © 2015 B. NGO NONGA-, EP. SAVOM, GA. BANG, GM LONDJI, AG. ESSOMBA-

oai:academicjournals.org:AATCVS:82F79F060847 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Surgical aspects of rheumatic heart disease: Part 2 A.T. PEZZELLA MD, N. NGUYEN MD Full Length Research Paper The overall global growth or expansion of cardiac surgery favors the developing countries and emerging economies. At present, it is estimated that over 2 million open-heart operations are performed annually worldwide. It is also estimated that over 10,000 cardiothoracic surgeons, in over 3,000 centers, that include specialty clinics, hospitals or institutes, be that public, private or charitable, are involved in that effort. Well over one million of these operations are performed in North America and Europe. This represents ready access or availability for less than 700 million of the 7 billion global population. An estimated backlog of 15-20 million people with heart disease are in need of corrective cardiac surgery worldwide. Whereas coronary artery disease is the dominant indication for cardiac surgery in the developed countries, rheumatic and congenital cardiac diseases continue to be more prevalent in the developing countries or emerging economies. Yet coronary artery disease and degenerative valve disease are also increasing in these countries as the global population health and lifespan improves and rises. As the social, economic, environmental, political, and demographic conditions in these countries evolve, adapt, and advance, there will be a concomitant increase in cardiac services that include prevention, awareness, diagnostic evaluation, medical management, interventional treatment, surgical procedures, rehabilitation, and early, mid-term, and long-term follow-up. Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain a serious and prevalent international concern. The global prevalence of RHD is 12-15 million, of which gt;2.4 million are children 5-14 years of age. The annual incidence is gt;300,000, and the annual mortality gt;350,000. Rheumatic mitral valve disease is the most common condition, especially in children. The incidence is greater in females, and lt;25% give a history of prior ARF. This represents 30-40% of all cardiac hospital admissions in developing countries. In sub-Saharan Africa (SSA), the echocardiogram (ECHO) in clinically silent patients detects from 7.5 to 56.6/1,000, as opposed to the lt;1.0 to 14/1,000 prevalence in clinically detected RHD. Regarding surgery, although open mitral valve repair has become the preferred procedure for degenerative and ischemic mitral valve problems, this procedure has not gained wide application for rheumatic disease, mainly because of complex pathology, technical difficulties, and debatable long term results, especially in children. Historically, mitral valve commissurotomy (MVC), both closed and open have been successful for rheumatic mitral stenosis, with excellent long term results. Presently, interventional percutaneous balloon valvuloplasty (PBV), when available and feasible, is the favored approach, despite higher cost than closed MVC. Open repair for rheumatic mitral regurgitation, though durable in experienced centers, has mixed long term results in children lt; 20 years of age. Other approaches, including valve replacement with mechanical or bioprosthetic valves, mitral Ross II procedure, mitral homografts, and leaflet extension using autologous or non-autologous pericardial substitutes, have all been described and advocated. Interventional percutaneous and trans-cardiac approaches to the mitral and aortic valves are now available in advanced centers, yet remain in the clinical investigative phases. Access for testing, monitoring, and regulation of anticoagulation in low and middle income populations remains a formidable challenge, as does appropriate surgical considerations and options in child-bearing females. The decreased growth potential and reduced durability of bioprosthetic valves in young patients, with attendant cost and need for reoperation, are also major considerations. The present part 2 review in a 5 part series highlights current medical and interventional treatment of predominate rheumatic mitral valve stenosis. Key Words Acute Rheumatic Fever, Rheumatic Heart Disease, Mitral commissurotomy, Percutaneous balloon valvotomy, valve surgery, valve repair Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/82F79F060847 http://dx.doi.org/10.5897/AATCVS.9000025 en Copyright © 2015 A.T. PEZZELLA MD, N. NGUYEN MD

oai:academicjournals.org:AATCVS:2B63E3460846 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Chirurgie a coeur ouvert en Afrique de l’Ouest: histoire, experience chirurgicale, et defis en Afrique de l’Ouest Yangni-Angate K.H. Technical Note Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/2B63E3460846 http://dx.doi.org/10.5897/AATCVS.9000008 en Copyright © 2015 Yangni-Angate K.H.

oai:academicjournals.org:AATCVS:F15C4BF60845 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015

Open heart surgery in West Africa: history, surgical experience, and challenges Koffi Herveacute; YANGNI-ANGATE Technical Note Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/F15C4BF60845 http://dx.doi.org/10.5897/AATCVS.9000018 en Copyright © 2015 Koffi Herveacute; YANGNI-ANGATE

oai:academicjournals.org:AATCVS:5D129A160755 2016-06-20T00:00:00Z AcademicJournals AATCVS AATCVS:2016

Surgical aspects of rheumatic heart disease: Part 3 A.T. PEZZELLA MD, N. NGUYEN MD Full Length Research Paper Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) remain significant noncommunicable diseases in developing countries and emerging economies. Part one of this five part series discussed general aspects of ARF and RHD. Part two focused on medical and interventional approaches and treatment. The present part three will focus on surgical aspects of RHD. This will highlight the history, indications, timing, and perioperative aspects of RHD. Emphasis will be placed on surgery in developing countries and emerging economies, where there are restrictions with relation to advanced technology, cost, access and availability of services, experience with repair techniques and care, as well as social and political constraints. Key-words: Acute Rheumatic Fever - Rheumatic Heart Disease - Surgery Academic Journals 2016 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/5D129A160755 http://dx.doi.org/10.5897/AATCVS.9000026 en Copyright © 2016 A.T. PEZZELLA MD, N. NGUYEN MD

oai:academicjournals.org:AATCVS:76924C060761 2016-06-20T00:00:00Z AcademicJournals AATCVS AATCVS:2016

Insurance type is a major predictor of lower extremity amputation following infra-popliteal arterial trauma JO. HWABEJIRE, C. NEMBHARD, AC. OBIRIEZE, Y. WEONPO, D. TRAN, DA. ROSE, M. SIRAM SURYANARAYANA, EE. CORNWELL III, H. KAKRA Full Length Research Paper Background: Following traumatic infrapopliteal arterial injury, salvageability of the leg is often attributed to injury-related variables. We investigated factors influencing amputation. Method: The United Statesrsquo; National Trauma Data Bank was retrospectively examined identifying subjects aged ge; 18 with tibial arterial injuries. Demographic, injury-related, co-morbid, and other variables were analyzed. Univariate and multivariable analyses determined predictors of lower extremity amputation. Results: 1921 subjects were included, mean age 38 years, 82% male, 65% had blunt injury, 58% white and 22% black. Insurance status: Private 24%, Self-Pay 20%, Medicare/Medicaid 17%, Other 14%, and Not-billed 1%. Average stay (days): ICU (4), hospital (15). Mortality was 2.5%. 13.6% had lower extremity amputation (10.6% below knee) and independent predictors of amputation were: male gender (OR:1.66,CI:1.11-2.34, P=0.012), Injury Severity Score (OR:1.62,CI:1.02-2.38, Plt;0.001), insurance status: Self-Pay (OR:1.76,CI:1.11-2.79, P=0.016), Medicare/Medicaid (OR:1.66, CI:1.03-2.67, P=0.039), Other (OR:1.61,CI:1.01-2.58, P=0.047), Notbilled (OR:1.52,CI:1.01-2.28, P=0.043). Conclusion: Insurance type is a major determinant of lower extremity amputation following traumatic infrapopliteal arterial injury. Keywords: Lower extremity amputation, arterial trauma, insurance Academic Journals 2016 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/76924C060761 http://dx.doi.org/10.5897/AATCVS.9000014 en Copyright © 2016 JO. HWABEJIRE, C. NEMBHARD, AC. OBIRIEZE, Y. WEONPO, D. TRAN, DA. ROSE, M. SIRAM SURYANARAYANA, EE. CORNWELL III, H. KAKRA

oai:academicjournals.org:AATCVS:859219B60759 2016-06-20T00:00:00Z AcademicJournals AATCVS AATCVS:2016

Côte cervicale inductrice d’un pseudo-anévrysme de l’artère sousclavière et d’un syndrome de la traversée thoraco-brachiale : À propos d’un cas à Yaoundé (Cameroun). T. MVOGO MINKALA LIN , B. NGO NONGA , S. ABOGO OYONG, P. ONGOLO ZOGO Full Length Research Paper La cote cervicale est une anomalie congeacute;nitale exceptionnelle, tout comme lrsquo;aneacute;vrysme de lrsquo;artegrave;re subclaviegrave;re qui est une pathologie rare. Nous rapportons le cas drsquo;un homme, travailleur manuel preacute;sentant des douleurs et gonflement cervical bas agrave; droite dont le bilan sceacute;nographique a reacute;veacute;leacute; une cocirc;te cervicale avec aneacute;vrysme de lrsquo;artegrave;re subclaviegrave;re Mots cleacute;s: cocirc;te cervicale, aneacute;vrysme Academic Journals 2016 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/859219B60759 http://dx.doi.org/10.5897/AATCVS.9000005 en Copyright © 2016 T. MVOGO MINKALA LIN , B. NGO NONGA , S. ABOGO OYONG, P. ONGOLO ZOGO

oai:academicjournals.org:AATCVS:BF3BC2460757 2016-06-20T00:00:00Z AcademicJournals AATCVS AATCVS:2016

Challenges in open heart surgery (OHS) in Africa: Côte d'Ivoire experience Koffi Herve Yangni-Angate, MD Technical Note I would like to thank the United States Chapter of the ISS (slide 3) for inviting me at the ACS clinical congress 2015(slide 4) and give me an opportunity to speak on rdquo;Challenges in Open Heart Surgery in Africa: Cote drsquo;Ivoire Experiencerdquo;(slide 5). Academic Journals 2016 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/BF3BC2460757 http://dx.doi.org/10.5897/AATCVS.9000006 en Copyright © 2016 Koffi Herve Yangni-Angate, MD

oai:academicjournals.org:AATCVS:B1BE19763331 2018-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2018

Chest surgical approaches in Africa: a constant challenge MENEAS GC, ABRO S, AND YANGNI-ANGATE KH. Objective: Thoracic surgical approach has taken a decisive turn since videoscopy utilization for cardiac and non-cardiac thoracic surgery. This study aims to present indications and results of chest surgical approaches performed in Cote drsquo;Ivoire. Methods: Using the 1998 and 2014 nationwide inpatient database, we identified retrospectivly 814 patients including 475 men and 339 women who underwent a cardiothoracic surgery. Mean age was 32.73 years; range was: 2 months - 88 years. Results: Cardiac Surgery was performed on 473 patients (58.10%) and Gene- ral Thoracic Surgery on 341 patients (41.89%). For Cardiac Surgery, median vertical sternotomy was the most surgical approach performed (n=250; 52.85%), while classic postero-lateral tho- racotomy was the most surgical approach performed in General Thoracic Surgery (n=321; 94.13%). Immediate postoperative pain required opioids administration in 84.39% of cases. Ave- rage length of hospitalization and healing were respectively 9.43 days (range: 2-50 days) and 18.30 days (range: 1-56 days). Conclusion: Development of minimally invasive chest approaches remains one of our challenges because those currently practiced are uncomfortable for patients and make longer hospital stay and wound healing. Keywords: Surgical Approach, Thorax, Minimally Invasive Procedures. Academic Journals 2018 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/B1BE19763331 http://dx.doi.org/10.5897/AATCVS.9000007 en Copyright © 2018 MENEAS GC, ABRO S, AND YANGNI-ANGATE KH.

oai:academicjournals.org:AATCVS:F990B0F63314 2018-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2018

Prise en charge des varices des membres inferieurs au centre hospitalier universitaire de brazzaville ATIPO-GALLOYE R, KOMBO BAYONNE S , NGOUNDA MONIANGA S A , OKIEMY GODEFFROY Aim : To describe epidemiological, clinical, etiologic, and therapeutic aspects of lower limbs varicose veins. Patients-methods : It was a retrospective study, carried out from May 2016 to June 2018 at Brazzaville teaching hospital. All patients who has been operated and medical records had surgical approach data were included. Patients were classified according to modified Hawai 2004 classification. Surgery and sclerotherapy were principals approaches used. Variables were ;demographic, clinicals etiologic, and therapeutic. Results : Forty five patients were operated, with average age of 42+/-2,5 ans. Sex ratio was 0,8. More than ninety percent of patients were symptomatic before treatment. Heaviness limbs was the most representative symptoms. Twenty six-seven percent of patients were admitted in stage C3. Varicose veins were essential in 55,5%, follow by post thrombotic varices with 17,8%. Superficial venous were more affected, and reflux was mojor pathophysiologic mechanism in 68,5%. Saphenous-femoral ligation with strippind and phlebectomies was the principal surgical technic. There were two cases of recidivism varicose veins after sclerotherapy. Conclusion : Varicose veins treatments in our context are still dominated by surgical approach. It will be better to add new vascular technics in our facility. Key words : Varicose veins, lower limbs, Brazzaville teaching hospital. Academic Journals 2018 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/F990B0F63314 http://dx.doi.org/10.5897/AATCVS.9000021 en Copyright © 2018 ATIPO-GALLOYE R, KOMBO BAYONNE S , NGOUNDA MONIANGA S A , OKIEMY GODEFFROY

oai:academicjournals.org:AATCVS:77EB43F63313 2018-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2018

The diagnosis and comprehensive management of congenital heart diseases in nations with severely restricted general and specialist healthcare services. VINICIUS NINA MD., PHD , EMILY FARKAS MD, FACS , RACHEL H NINA MD., PHD , JANINE HENSON RN., BSN., CCRN , AUBYN MARATH., MBBS., MS., FRCSED., ATLS Disease (CHD) in clinically sub-optimal settings. It is presented to provide simple diferences between certain conditions commonly seen in children with CHD for training doctors and nurses and other staff working within the speciality. In the majority of clinical presentations, a comprehensive, well structured training of a multidisciplinary team and carefully chosen hospital equipment and resources, can permit CHD to be safely and effectively treated by palliative or curative procedures. In our experience using this strategy, outcomes are almost comparable to those in advanced centers across the world. Among nations with severely restricted general and specialist healthcare resources, several issues must be overcome to diagnose and treat children with congenital heart diseases (CHD). The principal challenges to address are: Provider issues 1. Lack of primary and tertiary specialist facilities to support, diagnose, treat, implement follow-up care and preventive measures within the community so that avoidable complications of these diseases can be identified and minimized. 2. Lack of trained personnel in most of the specialties needed to support pediatric cardiac services Patient related issues 1. Maternal health issues affecting prematurity, dysmaturity, nutrition inadequacy during pregnancy threatening fetal development; 2. Child development issues: from insufficient nutritional support during post-natal growth; regionally limited, poor or absent primary healthcare; lack of preventative measures to reduce complications in such presentations ((for example, rheumatic fever, complicating CHD); With careful preparation using the algrorithms designed by CardioStart International, safely conducted complex operations can lead to good clinical outcomes throughout the peri-operative period. A vitally important component of these, is the ldquo;Dry Run Checklistrdquo; which allows the local team to confirm adequacy of equioment and disposables throughout the perioperative period. *[These are available on request] Key-words: congenital heart diseases, surgery, healthcare deprived or restricted, review Academic Journals 2018 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/77EB43F63313 http://dx.doi.org/10.5897/AATCVS.9000027 en Copyright © 2018 VINICIUS NINA MD., PHD , EMILY FARKAS MD, FACS , RACHEL H NINA MD., PHD , JANINE HENSON RN., BSN., CCRN , AUBYN MARATH., MBBS., MS., FRCSED., ATLS

oai:academicjournals.org:AATCVS:036BDFF63312 2018-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2018

Using technology and innovation to address the three delays in access to cardiac surgery. D. VERVOORT, MD.J. KPODONU, MD Cardiovascular diseases (CVD) make up the leading cause of mortality in the world with 17.65 million deaths every year, of which more than 80% occurs in low- and middle-income countries (LMICs). (1) With the ongoing shift of the global burden of CVD towards low-resource settings, a mortality rate of 25 million deaths is projected in these regions by 2030. (2) Nevertheless, it is estimated that 93% of the population in LMICs do not have access to safe cardiac surgical care, due to lack of nearby facilities, limited specialist and allied health workforce, and high risk of catastrophic expenditure. As such, there is a pressing need to address the barriers in receiving cardiac surgical care. Academic Journals 2018 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/036BDFF63312 http://dx.doi.org/10.5897/AATCVS.9000033 en Copyright © 2018 D. VERVOORT, MD.J. KPODONU, MD

oai:academicjournals.org:AATCVS:C6BA86162946 2020-02-29T00:00:00Z AcademicJournals AATCVS AATCVS:2020

Possible impairment of surgical decision making and confounded outcome in Fontan surgery by Nakata Index Mark N. Awori, Nikita P. Mehta, Naomi Kebba, and Joseph M. Mutie Full Length Research Paper Since cardiac structuring dimensions inform surgical decisions making, Z-score systematic error impairs surgical decision making and confounds outcome measurement, hence a similar error may affect the Nakata index. In this study, PubMed was searched using the terms: ldquo;pulmonary,rdquo; ldquo;artery,rdquo; ldquo;size,rdquo; ldquo;Nakata,rdquo; ldquo;Fontan,rdquo; and ldquo;outcomerdquo;. Studies that did not describe the outcome of the Fontan procedure and the size of the branch pulmonary arteries were excluded. Outcome measures of interest, in relation to BPA size, included: Operative mortality, Fontan ldquo;take-downrdquo;, length of ICU stay, pleural effusions and functional capacity. The results revealed that of 116 papers retrieved, 9 were included representing 1,042 patients who underwent the Fontan procedure. Six out of 9 papers representing 645 (61.9%) patients reported that BPA size had no relationship with the outcome of the Fontan procedure; while 2 out of 9 papers representing 366 (35.1%) patients found that BPA size did affect the outcome. One paper representing 31 (3%) patients was unable to find any relationship. All the papers that concluded that there was no relationship labelled normal sized BPAs as small because of a systematic error introduced by the Nakata index. Papers that found a relationship did not use the Nakata index. Thus, Nakata index systematic error may impair surgical decision making and confound outcome measurement in Fontan surgery. In addition, continued use of the Fontan index may have similar implications for other congenital heart lesions. Key words: Nakata Fontan mortality Academic Journals 2020 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/C6BA86162946 http://dx.doi.org/10.5897/AATCVS2019.0003 en Copyright © 2020 Mark N. Awori, Nikita P. Mehta, Naomi Kebba, and Joseph M. Mutie

oai:academicjournals.org:AATCVS:7D2A27067073 2021-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2021

Short-term follow-up of patients implanted with aortic valve bioprosthesis sutureless type Intuity Elite at the Robert Debré University Hospital in Reims (France) Katche Koutoua Eric, Souaga Kouassi Antonin, Kirioua-kamenan Yeboua Aimeacute;, Amani Kwadjau Anderson, Kendja Kouassi Flavien, Niava Gnamien Randolphe and Ruggieri Giovanni Full Length Research Paper To report the operative data, the immediate surgical results and the short-term follow-up of patients who were implanted with an Edwardsrsquo;s elite intuity bioprosthesis at the Thoracic and Cardiovascular Surgery Department of Reims (France). This was a retrospective and prospective study that was carried out from May 2015 to October 2017 in the Thoracic and Cardiovascular Surgery Department of the Robert Debreacute; Hospital. 20 patients were operated on for aortic valve stenosis using vertical midline sternotomy and quot;Lquot; ministernotomy approaches with implantation of a rapidly deploying aortic valve bioprosthesis of the Intuity Elite bioprosthesis type from Edwards Lifesciences. The results of the study showed that minimal leaks occured and a permanent dual chamber pacemaker was implanted in a patient for third degree atrioventricular block. Post-surgery symptoms observed in patients included dyspnea, palpitation and infectious Enterococcus faecium endocarditis. In conclusion, ldquo;Suturelessrdquo; valves allow easier surgical implantation and shorter aortic clamping times than sutured prostheses. Meanwhile, intuity Elite maintains a better transvalvular gradient. Key words: Elite intuity, follow-up, bioprosthesis, aortic valve. Academic Journals 2021 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/7D2A27067073 http://dx.doi.org/10.5897/AATCVS2021.0023 en Copyright © 2021 Katche Koutoua Eric, Souaga Kouassi Antonin, Kirioua-kamenan Yeboua Aimeacute;, Amani Kwadjau Anderson, Kendja Kouassi Flavien, Niava Gnamien Randolphe and Ruggieri Giovanni

oai:academicjournals.org:AATCVS:EEFE8BE67049 2021-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2021

Surgical repair of thoracic aortic aneurysm and dissection in the Sub-Saharan Africa: 30-day outcomes from a Cameroonian Center Charles Mve Mvondo, William Ngatchou, Hermann Nestor Tsague Kengni and Marcellin Ngowe Ngowe Full Length Research Paper The real incidence of thoracic aorta aneurysm and dissection (TAA) in the sub-Saharan region is unknown. Owing to diagnostic limitations and the absence of specialized centers, reports on TAA surgery have been anecdotal. We report our 30-day outcomes over an 8-year period following TAA surgery at the Shisong Cardiac Center, a Cameroonian cardio-surgical institution. Between November 2010 and May 2018, TAA was diagnosed in 35 patients at the Shisong Cardiac Center. Twenty eight (n=28) patients underwent surgical repair during the same period [Mean age: 43.8plusmn;14.7 years, range: 18-72 years; males: 18/28 (64.2%)]. Patient profiles, disease etiology and surgical outcomes were retrospectively reviewed. Uncontrolled hypertension was the commonest risk factor (17/28, 60.7%). Genetic disorders were found in 5/28 patients (17.8%) including 4 with bicuspid aortic valve and 1 with Marfanrsquo;s Syndrome. The operative mortality was 10.7% (n=3/28). Twenty one (n=22/28, 75%) patients had composite aortic root replacement (Bentall and De Bono); four patients (n=4/28, 14.2%) had ascending aorta graft replacement and two patients (n=2/28, 7.1%) underwent reductive aortoplasty (Robiscek). Associated procedures were mitral surgery (4/28, 14.2%), tricuspid repair (3/28, 10.7%) and CABG (1/28, 3.5%). One case of stroke was reported in the immediate postoperative period. The incidence of TAA in the sub-Saharan region seems to be underestimated due mainly to insufficient number of specialists and medical infrastructures. A major attention should be paid during the evaluation of patients with risk factors. These early results demonstrate the feasibility of surgical correction in our country with encouraging results. Key words: Thoracic aneurysm, aneurysm repair, Sub-Saharan Africa. Academic Journals 2021 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/EEFE8BE67049 http://dx.doi.org/10.5897/AATCVS2021.0024 en Copyright © 2021 Charles Mve Mvondo, William Ngatchou, Hermann Nestor Tsague Kengni and Marcellin Ngowe Ngowe

oai:academicjournals.org:AATCVS:B34241567587 2021-08-31T00:00:00Z AcademicJournals AATCVS AATCVS:2021

The relationship between peripheral arterial disease severity and allostatic load: A national health and nutrition examination survey study Kakra Hughes, Olubode A. Olufajo, Edmund Ameyaw, Kellee White, Dylan H. Roby, Craig S. Fryer, Joseph L. Wright, and Neil J. Sehgal Full Length Research Paper Major socioeconomic disparities persist in the management and outcomes of peripheral artery disease (PAD) globally. Allostatic load, which is described as a measure of physiologic adaptation to socio-environmental stress, has been reported to partially explain higher mortality rates in US Blacks. However, it is not clear if allostatic load is associated with PAD severity. The National Health and Nutrition Examination Survey (NHANES), 2003-2004 data was used to identify individuals with PAD based on the calculated Ankle-Brachial Index (ABI). After allostatic load was calculated for each individual, the cohort was stratified into tertiles of allostatic load and survey weights were used to generate nationally representative estimates. Factors associated with increased severity of PAD were evaluated using multivariate regression analyses. There were 5589 individuals included in the survey and 239 (5.9%) had PAD (ABI le; 0.9). Using survey weights, this corresponded to 5.9 million individuals. Individuals with PAD were more likely in the highest tertile of allostatic load (71%) compared to the middle (28%) or lowest (6%) tertiles. However, when severity of PAD was examined, the odds of moderate-to-severe PAD were not significantly different among individuals in the middle [adjusted Odds Ratio: 2.02 (0.52 - 7.80)] or highest [adjusted Odds Ratio: 2.53 (0.69 - 9.26)] tertiles compared to those in the lowest tertile. This study suggests that PAD severity is not associated with allostatic load. Increased efforts are necessary to identify factors that explain the socioeconomic disparities observed in the management and treatment of PAD. Key words: Allostatic load, outcomes, peripheral arterial disease, severity, socioeconomic. Academic Journals 2021 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/B34241567587 http://dx.doi.org/10.5897/AATCVS2021.0027 en Copyright © 2021 Kakra Hughes, Olubode A. Olufajo, Edmund Ameyaw, Kellee White, Dylan H. Roby, Craig S. Fryer, Joseph L. Wright, and Neil J. Sehgal

oai:academicjournals.org:AATCVS:48B28CD67585 2021-08-31T00:00:00Z AcademicJournals AATCVS AATCVS:2021

Comparison between ultrasound guided regional anaesthesia and general anaesthesia in arteriovenous fistula creation at the Douala General Hospital METOGO Mbengono Junette Arlette, HALLE Marie Patrice, MVE MVONDO Charles, TOUA Marie Michegrave;le, SANGO Joseph, MASSOM Annie, YAKANA Linus, MBAKOP Corinne, BEYIHA Geacute;rard, and NGATCHOU Djomo William, Full Length Research Paper Anaesthetic modalities for arteriovenous fistula (AVF) creation include general (GA), local (LA) and regional anaesthesia (RA). Ultrasound guided regional anaesthesia (USRA) proved to have more benefits in AVF creation than the other two. This study conducted at the Douala General Hospital aimed to assess these benefits over GA and RA. A retrospective review was performed on 217 records of patients who underwent an AVF creation between January 2015 and December 2018. The socio-demographic and clinical characteristics of patients were recorded. Analysis of variance, Pearsonrsquo;s chi-square test and binomial logistic regression were performed and a p value of lt;0.05 was considered significant. Of the 217 records reviewed, age ranged between 51 and 60 years old, and 71.9% were males. The distribution of AVF according to the anaesthetic type was: 83 (38.2%) for GA, and 68 (31.3%) for USRA. The rate of changeover was significantly associated with the anaesthetic type [GA: null vs. USRA: 8 (11.8%), p lt; 0.001]. The total anaesthesia administration time and surgical time were significantly associated with the anaesthetic type. The association between the anaesthetic type and the complication was of no statistical importance. This study thus showed that USRA was superior to either GA in AVF creation. The surgical duration mitigated the time required for its performance as compared to GA. It was the most stable in term of cost of anaesthesia and yielded higher rates of functional patency 3 months after the fistulae were created. Key words: Brachial plexus block, arteriovenous fistula, ultrasound, cost of anaesthesia, patency. Academic Journals 2021 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/48B28CD67585 http://dx.doi.org/10.5897/AATCVS2021.0026 en Copyright © 2021 METOGO Mbengono Junette Arlette, HALLE Marie Patrice, MVE MVONDO Charles, TOUA Marie Michegrave;le, SANGO Joseph, MASSOM Annie, YAKANA Linus, MBAKOP Corinne, BEYIHA Geacute;rard, and NGATCHOU Djomo William,

oai:academicjournals.org:AATCVS:568625167903 2021-10-31T00:00:00Z AcademicJournals AATCVS AATCVS:2021

Surgical management and long term postoperative follow-up of atrial septal defects in adults Kouassi Antonin SOUAGA, Jean Calaire DEGREacute;, Koutouan Eric KATCHEacute;, Yoboua Aimeacute; KIRIOUA-KAMENAN, Kwadjau Anderson AMANI, Gnamien Randolph NIAVA, Kouadio Joseph KOUAME, Landry KOHOU-KONE, Yves N#;GORAN, Kouassi Flavien KENDJA, Michel KANGAH Full Length Research Paper The aim is to report an Ivorian experience of the surgical management of atrial septal defects in adulthood. Our retrospective study included 19 patients over 18 years old operated on for atrial septal defects (ASD) between January 2005 and December 2015 at the Abidjan Heart Institute (AHI). 13 women and 6 men with a mean age of 26plusmn;9.07 years were included. For each patient we noted the clinical and para-clinical signs as well as the operative result and the short and long term follow-up data. Patients were symptomatic in 73.7% of cases. Two patients had atrial flutter. On cardiac echo-Doppler, the right ventricle measured 43.5 plusmn;4.2 mm. The systolic pulmonary artery pressure was 45 plusmn; 14.7 mmHg. There were 3 cases of grade III tricuspid insufficiency and 1 case of abnormal venous return. Closure of the septal defect was performed with an autologous pericardial patch in 18 cases. Operative mortality was nil. The average length of stay in the surgical intensive care unit was 2.5 days. Eleven patients presented immediate postoperative complications, including 2 cardiac and 9 extracardiac. The total postoperative hospital stay was 14.7 days. After a mean follow-up of 8.25 plusmn; 4 years, all patients had functional improvement with a significant decrease in right ventricular size and pulmonary arterial pressure. Surgical management of atrial septal defects in adulthood is associated with low mortality with a satisfactory functional outcome. Key words: Atrial septal defect, surgical closure, adult. Academic Journals 2021 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/568625167903 http://dx.doi.org/10.5897/AATCVS2021.0028 en Copyright © 2021 Kouassi Antonin SOUAGA, Jean Calaire DEGREacute;, Koutouan Eric KATCHEacute;, Yoboua Aimeacute; KIRIOUA-KAMENAN, Kwadjau Anderson AMANI, Gnamien Randolph NIAVA, Kouadio Joseph KOUAME, Landry KOHOU-KONE, Yves N#;GORAN, Kouassi Flavien KENDJA, Michel KANGAH

oai:academicjournals.org:AATCVS:185F78968081 2021-11-30T00:00:00Z AcademicJournals AATCVS AATCVS:2021

Bovine aortic arch: Cases report B. Aziza Review A bovine aortic arch is the most common variant of aortic arch branching in humans with a frequency ranging from 15 to 27% (1-2). It will be considered as a risk factor for aortopathy as anevrysm and dissection. Two cases were reported with association of bovine aortic arch and aortopathy. In both cases, the discovery of the anomaly of the aortic arch was fortuitous. A bovine aortic arch is frequent in patients with thoracic aortic disease than in the general population with a rapid evolution on the diameter of the aorta which expose patients to more complications such as anevrysm, rupture and dissection. It will be considered as a risk factor for aortopaty. Key words: Bovine aortic arch, aortopathy, common birth aortic arch. Academic Journals 2021 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/185F78968081 http://dx.doi.org/10.5897/AATCVS2020.0011 en Copyright © 2021 B. Aziza

oai:academicjournals.org:AATCVS:E8500E668089 2021-11-30T00:00:00Z AcademicJournals AATCVS AATCVS:2021

Use of a composite survival curve to optimise timing of surgical repair of Truncus arteriosus Mark N Awori, Jonathan A. Awori and Nadia Makkoukdji Full Length Research Paper Surgical repair of Truncus arteriosus aims to improve long term survival. A clear understanding of the natural history and achievable surgical outcomes informs surgical decision making with respect to the timing of surgery. We sought to determine if it is ever too late to repair T. arteriosus. Pubmed and Google scholar were searched between January 1st 1966 and July 31st 2021. The proximal similarly model was used to determine the most externally valid natural history and surgical outcome data. The most externally valid data were used to develop a composite survival graph to help clinicians optimize surgical decision making. Four hundred and twenty eight results were retrieved. Five studies representing 938 patients who had repair of T. arteriosus were included for external validity assessment. The resultant composite graph suggests that repair after 5 month of age, may not improve 15 year survival when compared to non-operative care. T. arteriosus repair after 5 months of age may not improve survival. Key words: Pediatric, truncus artriosus, operative, outcomes. Academic Journals 2021 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/E8500E668089 http://dx.doi.org/10.5897/AATCVS2021.0029 en Copyright © 2021 Mark N Awori, Jonathan A. Awori and Nadia Makkoukdji

oai:academicjournals.org:AATCVS:98885C368496 2022-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2022

Native arteriovenous fistulas in hemodialysis patients: Our experience with 1467 patients operated on in Abidjan Kouassi Antonin Souaga, Eric Koutoua Katcheacute;, Jean Calaire Degreacute;, Gnamien Randolph Niava, Kwadjau Anderson Amani, Yoboua Aimeacute; Kirioua-Kamenan, Joseph Kouameacute;, Yao Hubert and Kouassi Flavien Kendja Full Length Research Paper This study aim to report our experience in the fabrication of arteriovenous fistulas (AVF) by describing the operative technique and the immediate surgical results. The study carried out retrospective study of the records of 1467 patients who underwent AVF creation during the period from January 2008 to December 2020. 1396 patients (95.2%) had already been dialyzed with a central venous catheter for one month (1 and 6 months). The procedures were performed under local anesthesia. Distal radio-cephalic AVFs were performed in 92.2% of cases. The fabrication of a radio cephalic arteriovenous fistula was described. The arteriovenous fistulas were patented in 100% at the end of the procedure. We observed 3.1% complications in the immediate postoperative period. Morbidity was constituted by early thrombosis which represented 58.8% of complications followed by false aneurysms (27.5%), compressive hematomas (11.8%) and hemorrhages (1.9%). Fistulas complicated by thrombosis were reconnected. Treatment of the false aneurysm consisted of evacuation of the false aneurysm, surgical hemostasis, and removal of the AVF. The native arteriovenous fistula is the best access route for chronic hemodialysis. This procedure carries little risk. However, complications can be fatal, hence the interest of an early and adapted management of these complications. Key words: Arteriovenous fistula, hemodialysis, vascular access. Academic Journals 2022 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/98885C368496 http://dx.doi.org/10.5897/AATCVS2021.0033 en Copyright © 2022 Kouassi Antonin Souaga, Eric Koutoua Katcheacute;, Jean Calaire Degreacute;, Gnamien Randolph Niava, Kwadjau Anderson Amani, Yoboua Aimeacute; Kirioua-Kamenan, Joseph Kouameacute;, Yao Hubert and Kouassi Flavien Kendja

oai:academicjournals.org:AATCVS:F34A3E168553 2022-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2022

Use of a composite survival curve to determine the age at which surgery offers the highest survival benefit for Tetralogy of Fallot Mark N Awori, Jonathan A Awori, and Nick K Gachara Full Length Research Paper Contemporary surgical practice relating to Tetralogy of Fallot is shifting towards earlier correction; however, a recent large study proposes later correction to increase event free survival. Surgery aims to improve the quantity and quality of life at minimal risk to the patient. Surgical outcome and risk assessment requires a comparison of externally valid studies of natural history and surgical outcome. The authors reviewed the literature to identify the most externally valid natural history and surgical outcome data and used it to develop a composite survival graph to help clinicians determine when surgery would offer the greatest survival advantage. The composite graph suggests that, for symptomatic patients, the greatest survival advantage occurs when corrective surgery is performed within the 1st week of life. Key words: Pediatric, tetralogy of Fallot, operative, outcomes. Academic Journals 2022 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/F34A3E168553 http://dx.doi.org/10.5897/AATCVS2021.0030 en Copyright © 2022 Mark N Awori, Jonathan A Awori, and Nick K Gachara

oai:academicjournals.org:AATCVS:422DDB268643 2022-02-28T00:00:00Z AcademicJournals AATCVS AATCVS:2022

Use of a composite survival curve to optimise the surgical strategy for repair of transposition of the great arteries Mark N. Awori, Jonathan A Awori, Nadia Makkoukdji and Stephen Takow Full Length Research Paper The arterial switch operation (ASO) is considered the gold standard for repair of D-transposition of the great arteries. However, when patients present after the third week of life, the early operative outcomes may be less predictable. Current guidelines recommend extra corporeal membrane oxygenation (ECMO) availability when the arterial switch is performed on patients between 3 to 6 weeks of age. Controversy remains regarding the safe upper age limit for a successful arterial switch operation. An objective assessment of the efficacy of a treatment requires a comparison of the treatment outcome with the natural history. We reviewed the literature and used the most externally valid data to create a composite survival curve that facilitates the comparison of surgical outcome and natural history. The data suggest that, where ECMO is available, the ASO is the best option for patients at any age up to 14 weeks old. The ASO is also the best option for patients up to 2 weeks of age where ECMO is not available. The atrial switch operation (AtSO) is the best option for patients between 2 weeks and 14 weeks of age where ECMO is not available. The ASO or the AtSO should be offered as soon as possible after birth; surgery after 14 weeks of age may not improve 10 year survival compared to the natural history. Key words: Pediatric, transposition great arteries, operative, outcomes. Academic Journals 2022 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/422DDB268643 http://dx.doi.org/10.5897/AATCVS2021.0031 en Copyright © 2022 Mark N. Awori, Jonathan A Awori, Nadia Makkoukdji and Stephen Takow

oai:academicjournals.org:AATCVS:93D9EE068912 2022-03-31T00:00:00Z AcademicJournals AATCVS AATCVS:2022

The sum of its parts: The importance of methodology on presented data Rohit S. Loomba Editorial Academic Journals 2022 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/93D9EE068912 http://dx.doi.org/10.5897/AATCVS2022.0037 en Copyright © 2022 Rohit S. Loomba

oai:academicjournals.org:AATCVS:579EA9369684 2022-09-30T00:00:00Z AcademicJournals AATCVS AATCVS:2022

Modified ultrafiltration does not improve outcome of pediatric cardiac surgery: A meta-analysis Mark Nelson Awori, Jonathan Alan Awori, Pravin Momanyi Mokaya and Kimberly Kipkoech Full Length Research Paper Although it is generally accepted that modified ultrafiltration (MUF) improves operative outcomes in pediatric cardiac surgery, the evidence for this remains equivocal. Previous meta-analyses have been affected by significant patient and method heterogeneity. Google Scholar and PUBMED were searched between January 1st 1966 and May 31st 2022. We conducted a meta-analysis after pragmatically minimising patient and method heterogeneity. There were 631 patients (314 MUF vs 317 lsquo;No MUFrsquo;) in the the mortality analysis and 258 patients (129 MUF vs 129 lsquo;No MUFrsquo;) in the lsquo;duration-of-ventilationrsquo; (DOV) and lsquo;length-of-hospital stayrsquo; (LOHS) analyses. There was no significant difference in operative mortality, DOV and LOHS. There is no evidence that MUF improves these operative outcomes in paediatric cardiac surgery. Key words: Modified ultrafiltration, pediatric, cardiac surgery. Academic Journals 2022 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/579EA9369684 http://dx.doi.org/10.5897/AATCVS022.0048 en Copyright © 2022 Mark Nelson Awori, Jonathan Alan Awori, Pravin Momanyi Mokaya and Kimberly Kipkoech

oai:academicjournals.org:AATCVS:64B9E0E70394 2023-03-31T00:00:00Z AcademicJournals AATCVS AATCVS:2023

Endovascular and conventional surgical treatment of aneurysms of the aorta and its main branches in Sub-Saharan Africa: The experience of the Côte d'Ivoire Yoboua Aimeacute; KIRIOUA-KAMENAN, Kwadjau Anderson AMANI, Kouassi Antonin SOUAGA, Jules SEI BI GOURIAN, Afif GHASSANI,Koutoua Eric KATCHE, Jean Calaire DEGRE, Randolphe NIAVA, Lucien ASSEKE, Joseph KOUAME and Flavien KENDJA Full Length Research Paper The objective of this retrospective descriptive study is to share the experience of the Abidjan Heart Institute in the global management of aneurysms of aorta and its main branches from January 2007 to February 2022. It focused on the medical records of patients operated on for an aneurysm of the aorta and its main branches at the Abidjan Heart Institute. The following parameters were studied: Age, sex, circumstances of discovery, degree of urgency, anatomical-clinical characteristics thanks to CT angiography, approaches, operative techniques, duration of interventions, duration of stay in intensive care and in hospital, immediate, short and medium term post-operative results. Thirty seven medical records were collected. Twenty-nine (78.4%) patients were male and eight (21.6%) were female. The average age of the patients was 52.36 years. The circumstances of discovery were represented by clinical signs in 56.8%, while 29.7% were incidental findings, and by complications in 13.5%. CT angiography revealed 48.7% of aneurysms located in the sub-renal abdominal aorta, 10.8% of aneurysms located in the aorto-biiliac portion, 10.8% of the aneurysms were located on the common iliac arteries, 8.1% on the ascending aorta, 18.9% on the descending thoracic aorta and 02.7% on the left renal artery on a single kidney. The saccular anatomical type was observed in 32.4% and the fusiform type in 67.6%. Conventional surgery was performed in 75.7% and the endovascular procedure in 24.3%. These two complementary methods have considerably improved the management of patients with aortic aneurysms in Cocirc;te d#39;Ivoire in recent years. Key words: Aneurysms of aorta and its main branches, conventional surgery, endovascular procedure. Academic Journals 2023 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/64B9E0E70394 http://dx.doi.org/10.5897/AATCVS022.0050 en Copyright © 2023 Yoboua Aimeacute; KIRIOUA-KAMENAN, Kwadjau Anderson AMANI, Kouassi Antonin SOUAGA, Jules SEI BI GOURIAN, Afif GHASSANI,Koutoua Eric KATCHE, Jean Calaire DEGRE, Randolphe NIAVA, Lucien ASSEKE, Joseph KOUAME and Flavien KENDJA

oai:academicjournals.org:AATCVS:E07DCED70396 2023-03-31T00:00:00Z AcademicJournals AATCVS AATCVS:2023

Management of axillary artery injuries at the University Hospital of Tengandogo: Report of two cases Adama Sawadogo, Moussa Bazongo, Farid Pingwindeacute; Belem, Rodrigue Namegrave;kinsba Doamba, Gilbert Bonkoungou and Adama Sanou Case Report Early repair of axillary artery injuries is a key decision that can minimize the potential for mortality and severe morbidities. The authors report two cases of major traumas of the shoulder that lead to axillary artery injuries. The case 1 is a 30 years old police man who presented explosion of the left axillary artery due to gunshot. A revascularization Dacron tube was successfully performed. The case 2 was aged 36 years old and was an engineer. He suffered from traumatic section of the right axillary artery that happened during a traffic accident. An open repair with Dacron tube was performed on time. The right upper limb was preserved. Axillary artery injuries occur during the violent and major traumas of the shoulder and thorax and lead to high rate of amputation of the upper limb. Now in sub-saharan Africa, under some circumstances, it is possible to successfully repair the injured axillary arteries. Key words: Axillary artery, arterial wound, vascular surgery, Burkina Faso. Academic Journals 2023 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/E07DCED70396 http://dx.doi.org/10.5897/AATCVS022.0046 en Copyright © 2023 Adama Sawadogo, Moussa Bazongo, Farid Pingwindeacute; Belem, Rodrigue Namegrave;kinsba Doamba, Gilbert Bonkoungou and Adama Sanou

oai:academicjournals.org:AATCVS:3F75ABF70591 2023-04-30T00:00:00Z AcademicJournals AATCVS AATCVS:2023

Use of a composite survival graph to optimise the surgical strategy for Tricuspid atresia Mark N. Awori, Jonathan A. Awori, Hassan Mohamud Ibrahim and Kimberly Kipkoech Full Length Research Paper The introduction of the Fontan circulation has improved the long term survival of patients with Tricuspid Atresia (TA) in general. Neonates and infants with TA presenting reduced pulmonary blood flow (RPBF) are usually offered a systemic arterial-to-pulmonary artery shunt (SAPAS) in the hope that they will eventually achieve a Fontan circulation. There is evidence that palliative surgery may not improve survival in this subset of patients. Our aim was to determine whether palliative surgery improves survival in patients with TA and RPBF. An objective assessment of a treatment outcome necessitates a comparison of the treatment outcome with the natural history. We searched the literature for surgical outcome and natural history studies. The most external validity ones were used to create a composite survival graph to assess the efficacy of palliative surgery in patients with TA and RPBF. The data suggests that palliative cardiac surgery in patients with TA and RPBF is unlikely to improve the long-term survival compared to the natural history. There is also evidence that palliative cardiac surgery performed on patients with TA, who present for the first time after one year of age, is unlikely to improve long-term survival compared to the natural history. Palliative cardiac surgery should not be offered to patients with TA and RPBF. Palliative cardiac surgery probably should not be offered to any patient with TA who presents for the first time after 1 year of age. Key words: Tricuspid atresia, surgery outcome. Academic Journals 2023 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/3F75ABF70591 http://dx.doi.org/10.5897/AATCVS022.0044 en Copyright © 2023 Mark N. Awori, Jonathan A. Awori, Hassan Mohamud Ibrahim and Kimberly Kipkoech

oai:academicjournals.org:AATCVS:021F14470601 2023-04-30T00:00:00Z AcademicJournals AATCVS AATCVS:2023

Late repair of truncus arteriosus improves the symptoms in the majority of patients: A systematic review Mark N. Awori, Jonathan A. Awori, Jedida Chepkorir Kimutai, Pravin Mokaya Momanyi and Kimberly Kipkoech Full Length Research Paper Surgery aims to increase longevity and improve symptomatology. Surgical correction of truncus arteriosus after five months of age does not appear to offer a survival advantage over the natural history; repair after 5 months of age can be considered to be lsquo;latersquo; in this regard. Although surgical correction after five months of age can be achieved with low operative mortality, it remains unclear whether symptomatology is improved. Pubmed and Google scholar were searched between January 1st 1966 and September 30th 2022. Search terms included: Truncus, arteriosus, correction, repair, New York Heart Association, symptoms, and functional. Papers that included patients who had truncus arteriosus repair after the age of 5 months were examined. Three hundred and sixty seven results were obtained; 44 full-text papers were reviewed, seven full-text papers representing 16 patients were included. Surgical repair improved symptoms in 14 of 16 (87.5 plusmn; 18.3; 95% CI) patients who had surgery after 5 months of age. Surgical correction of truncus arteriosus after 5 months of age improves symptoms in the majority of operable patients. Key words: Pediatric, truncus artriosus, operative, outcomes. Academic Journals 2023 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/021F14470601 http://dx.doi.org/10.5897/AATCVS022.0051 en Copyright © 2023 Mark N. Awori, Jonathan A. Awori, Jedida Chepkorir Kimutai, Pravin Mokaya Momanyi and Kimberly Kipkoech

oai:academicjournals.org:AATCVS:44BB1CD71015 2023-07-31T00:00:00Z AcademicJournals AATCVS AATCVS:2023

Clinical experience showing arterial traumas of limbs and the neck for more than sixteen consecutive years of civil practice in Abidjan Yoboua Aimeacute; Kirioua-Kamenan, Jean Calaire Degr, Koutoua Eric Katcheacute;, Mariam Gnoundan Bamba, Assoumou Lucien Asseke, Ibrahim Junior Yeo, Kwadjau Anderson Amani, Kouassi Antonin Souaga, Marc Herveacute; Kassi, Zoleacute; Cedrick Doh and Kouassi Flavien Kendja, Full Length Research Paper To share our experience regarding the treatment of limb and neck arterial traumas, we conducted a retrospective descriptive study using the medical records of patients who underwent surgical repair at the Abidjan Heart Institute between August 2005 and March 2022. The epidemiological, anatomo-clinical and therapeutic parameters were studied. 1073 patient records were collected. There were 108 females and 965 males. The average age of the patients was 28 years old. The circumstances of occurrence were dominated by assaults in 61.79% of cases. The anatomical lesions consisted of the arterial lateral wound in 48.09% of cases, the complete section of the artery in 29.08% of cases, the loss of arterial substance in 07.27% of cases, the arterial contusion in 04.38% of cases, the arteriovenous fistula in 02.61% of cases, and the false aneurysm in 08.57% of cases. The lesions were located on the upper limb arteries in 47.72% of cases, on the lower limb arteries in 39.05% of cases and on the neck in 13.23% of cases. Injurious agents included stabbing in 44.36% of cases, firearm in 19.29% of cases, traffic accident in 34.76% of cases, iatrogenic agents in 1.30% of cases and the fishbone in 3 cases (00.28%). Vascular repair had consisted of direct suture, patch closure, prosthetic or venous bypass, or flattening-graft. Traumatic arterial lesions are dominated by lateral wounds and complete sections. Their delay in therapeutic management is still too long due to the late arrival at the hospital and constitutes the major factor of poor prognosis. However, even unrecognized at the acute stage, certain arterial lesions can progress to chronicity, marked by arteriovenous fistula and false aneurysm. Key words: Arteriovenous fistula, false aneurysm, flattening-graft, limbs and neck arterial traumas, prosthetic bypass. Academic Journals 2023 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/44BB1CD71015 http://dx.doi.org/10.5897/AATCVS023.0057 en Copyright © 2023 Yoboua Aimeacute; Kirioua-Kamenan, Jean Calaire Degr, Koutoua Eric Katcheacute;, Mariam Gnoundan Bamba, Assoumou Lucien Asseke, Ibrahim Junior Yeo, Kwadjau Anderson Amani, Kouassi Antonin Souaga, Marc Herveacute; Kassi, Zoleacute; Cedrick Doh and Kouassi Flavien Kendja,

oai:academicjournals.org:AATCVS:9AC733B71054 2023-08-31T00:00:00Z AcademicJournals AATCVS AATCVS:2023

Takayasu disease revealed by aortic insufficiency associated with an aneurysm of the ascending aorta Kouassi Antonin Souaga, Koutoua Eric Katche, Yoboua Aimeacute; Kirioua-Kamenan, Kwadjau Andersn Amani, Jean Calaire Degreacute;, Gnamien Randolph Niava, Joseph Kouame, Landry Kohou-Kone and Kouassi Flavien Kendja Case Report Takayasu#39;s disease is a rare inflammatory disease of unknown etiology that affects the large vessels, particularly the aorta and its major branches. A case of 29-year-old patient received for surgical management of severe aortic insufficiency was reported. Preoperative clinical and paraclinical investigations revealed a dilatation of the ascending aorta associated with a stenosis of the left subclavian artery and an inflammatory syndrome. This patient underwent a successful Banhson operation. Pathological analysis of the surgical specimen confirmed the diagnosis of Takayasu disease. In conclusion, aortic valve replacement combined with ascending aorta replacement performed in an inflammatory context was successful. However, it requires monitoring to detect complications related to tissue fragility. Key words: Takayasu disease, aortic insufficiency, aneurysm. Academic Journals 2023 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/9AC733B71054 http://dx.doi.org/10.5897/AATCVS021.0035 en Copyright © 2023 Kouassi Antonin Souaga, Koutoua Eric Katche, Yoboua Aimeacute; Kirioua-Kamenan, Kwadjau Andersn Amani, Jean Calaire Degreacute;, Gnamien Randolph Niava, Joseph Kouame, Landry Kohou-Kone and Kouassi Flavien Kendja

oai:academicjournals.org:AATCVS:BFE596271119 2023-08-31T00:00:00Z AcademicJournals AATCVS AATCVS:2023

Surgical repair of a giant right coronary artery aneurysm with intra-cardiac fistulas: A case report Adama Sawadogo, Nibeacute;puo Hippolyte Someacute;, Farid Pingwinde Belem, Moussa Bazongo, Gilbert Bonkoungou, Adama Sanou and Lionel Camilleri Case Report Coronary artery aneurysms (CAA) are rare and life-threatening cardiovascular abnormalities. Multiple aneurysms and giant aneurysms are even rarer. The authors report a case of a giant CAA (7 cm) in a 62-year-old male patient with multiple cardiovascular risks. In fact, there were three adjacent aneurysms of the right coronary artery (RCA) that were connected to the cardiac chambers through two fistulas. Additionally, there was significant stenosis of the left anterior descending (LAD) at segment II. The patient underwent double coronary artery bypass grafting (RCA and LAD) and aneurysm repair under cardiopulmonary bypass. Despite a few early postoperative complications, the results in terms of myocardial revascularization were good, and the patient was discharged from the hospital on the 18th day postoperatively. Key words: Coronary artery aneurysm, cardiac fistula, ischemic heart, coronary artery bypass Academic Journals 2023 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/BFE596271119 http://dx.doi.org/10.5897/AATCVS022.0047 en Copyright © 2023 Adama Sawadogo, Nibeacute;puo Hippolyte Someacute;, Farid Pingwinde Belem, Moussa Bazongo, Gilbert Bonkoungou, Adama Sanou and Lionel Camilleri

oai:academicjournals.org:AATCVS:DC13C3E71292 2023-09-30T00:00:00Z AcademicJournals AATCVS AATCVS:2023

Current status of the pediatric congenital heart disease management pathway in low and low-middle income countries: A review Mark Nelson Awori, Daniel Ojuka, Diana Marangu and Paul Bannon Review There is evidence that children with congenital heart disease (CHD) in low and low-middle income countries (LMICs) do not have access to timely intervention. The concept of the lsquo;Management Pathwayrsquo; (MP) for CHD has been developed to facilitate a pragmatic assessment of the quality of care. The MP is comprised three phases: diagnosis, treatment (intervention) and follow-up. Best practice recommendations regarding how each phase should be executed have been published. The fundamental tenets of these recommendations can be summarised as follows: timely diagnosis, timely treatment and robust follow-up. We aimed to examine the status of the MP in LMICs. Google Scholar and PUBMED were searched between January 1st 1966 and August 31st 2022. Twenty-nine articles, representing 43,082 patients were included: sixteen (55.2%) were from Asia; eight (27.6%) were from Africa; three (10.3%) were regional and two (6.9%) were from the Middle East. Twelve (41.4%) studies examined two phases of the MP: eleven examined diagnosis and treatment; one examined treatment and follow-up. Eight (27.6%) studies did not examine the MP at all and only one (3.4%) examined all three phases of the MP. The majority of studies found that MP phases had not been executed as recommended. No study found that all the three phases of the MP had been executed as recommended. Most papers revealed that best practice goals for the MP were not achieved; it is likely that most children with CHD in LMICs do not receive optimal surgical intervention. Key words: Congenital heart, disease, treatment, low, middle income, countries. Academic Journals 2023 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/DC13C3E71292 http://dx.doi.org/10.5897/AATCVS023.0055 en Copyright © 2023 Mark Nelson Awori, Daniel Ojuka, Diana Marangu and Paul Bannon

oai:academicjournals.org:AATCVS:2BE08F771860 2024-02-29T00:00:00Z AcademicJournals AATCVS AATCVS:2024

The magnitude of systemic arterial oxygen saturation improvement achievable by a Blalock-Taussig-Thomas shunt: A systematic review Mark N. Awori, Jonathan A. Awori, Gilbert Langat and Kimberly Kipkoech Full Length Research Paper This study was carried out to determine the magnitude of systemic arterial oxygen saturation (SaO2) improvement caused by a Blalock-Taussig-Thomas shunt (BTTS). PUBMED (PM) and Google Scholar (GS) were searched between 1st January, 1966 and 31st March, 2023. Search terms included: Blalock, Taussig, shunt, pulmonary artery and Tetralogy of Fallot. Only full-text papers that measured pre-BTTS and post-BTTS systemic arterial oxygen saturation were included. Of 153 records retrieved, 12 full-text articles (427 patients) were included in this review. The mean pre-BTTS and post-BTTS SaO2 were 69.9 and 86.9%, respectively. Nine out of 12 studies representing 371 patients (86.8%) had a post-BTTS increase in SaO2 of 20% or less. Available evidence suggests that a BTTS is unlikely to increase the SaO2 by more than 20% in almost 90% of patients. This finding may have important implications for the continued use of BTTS to raise the SaO2 in patients with severe cyanosis. Key words: Blalock, Taussig, Thomas, arterial, oxygen, saturation. Academic Journals 2024 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/2BE08F771860 http://dx.doi.org/10.5897/AATCVS023.0060 en Copyright © 2024 Mark N. Awori, Jonathan A. Awori, Gilbert Langat and Kimberly Kipkoech

oai:academicjournals.org:AATCVS:B8DE3F472040 2024-04-30T00:00:00Z AcademicJournals AATCVS AATCVS:2024

Lower mini-sternotomy for atrial septal defect repair in a young African woman Mve Mvondo Charles, Ngo Yon Laurence Carole, Kobe Fokalbo Zephanie, Tsague Kengni Hermann Nestor, Dakleu Mireille, Menanga Alain Patrick, Djientcheu Vincent de Paul, and Ngowe Ngowe Marcelin Case Report Minimally invasive cardiac surgery (MICS) as an alternative to the traditional full sternotomy approach has gained major interest in recent decades. Compared to conventional techniques, MICS has been associated with a shorter hospital stay, reduced risk of infection, and better cosmetic results. We report the case of a 28-year-old female who underwent surgical repair of ostium secundum atrial septal defect (OSASD) via a lower mini-sternotomy (LMS). Key words: Minimally access cardiac surgery, atrial defect, sub-Saharan Africa. Academic Journals 2024 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/B8DE3F472040 http://dx.doi.org/10.5897/AATCVS023.0058 en Copyright © 2024 Mve Mvondo Charles, Ngo Yon Laurence Carole, Kobe Fokalbo Zephanie, Tsague Kengni Hermann Nestor, Dakleu Mireille, Menanga Alain Patrick, Djientcheu Vincent de Paul, and Ngowe Ngowe Marcelin

oai:academicjournals.org:AATCVS:2BC592F72067 2024-04-30T00:00:00Z AcademicJournals AATCVS AATCVS:2024

Surgical therapy of patent ductus arteriosus in Burkina Faso: Study of the first 23 cases performed at the University Hospital of Tengandogo Adama Sawadogo, Moussa Bazongo, Farid Pingwindeacute; Belem, Hippolyte Nebepoua Someacute;, Souhdou Ky, Rodrigue Namegrave;kinsba Doamba, Amadou Gabriel Ciss, Lionel Camilleri and Adama Sanou Full Length Research Paper Cardiac surgery performance by a local team in Burkina Faso began in 2019. The first procedure was the surgical division of patent ductus arteriosus (PDA). In this study, the authors report the outcomes of the first 23 surgical therapies for PDA performed at the University Hospital of Tengandogo (UHT). It consisted of a retrospective and descriptive study at the UHT from April 9th, 2019, to August 9th, 2021. All cases of PDA treated by surgical methods were included. Then, epidemiological, clinical, echocardiographic, and evolutionary data were assessed. Overall, 23 cases of PDA were enrolled, and the M-F ratio was 0.53. The mean age was 4.9 years old [1; 16 years old]. Dyspnea and recurrent respiratory infections were the most reported symptoms in 82.6 and 73.9% of the cases, respectively. Physical examination found a continuous murmur at the upper left sternal border and tachycardia in 95.6 and 86.9% of the cases, respectively. The surgical approach was a left posterolateral thoracotomy through the 4th intercostal space. Surgical division was performed in 20 cases (87%) versus surgical ligation in 3 cases (13%). Postoperatively, 1 case of infection at the surgical site and 1 case of chylothorax were found. The mean hospital stay was 12 days [7; 26 days]. The death rate was nil. Surgical therapy by thoracotomy is effective and safe. To improve the management of this congenital heart defect, antenatal diagnosis, medical therapy and transcatheter closure are to be promoted. Key words: Patent ductus arteriosus, congenital heart disease, closed cardiac surgery, cardiac surgery, Burkina Faso. Academic Journals 2024 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/2BC592F72067 http://dx.doi.org/10.5897/AATCVS2022.0056 en Copyright © 2024 Adama Sawadogo, Moussa Bazongo, Farid Pingwindeacute; Belem, Hippolyte Nebepoua Someacute;, Souhdou Ky, Rodrigue Namegrave;kinsba Doamba, Amadou Gabriel Ciss, Lionel Camilleri and Adama Sanou